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General NPI Number Information
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NPI Number | 1235690124
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Entity Type | Individual
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Provider Name | ALEXANDER RYAN POWELL DDS
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Gender | Male
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 4350 MARCONI AVE STE 200
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City | SACRAMENTO
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State | CA
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Zip | 95821-4379
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Country | US
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Telephone | 916-483-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 6013 SUNDALE CT
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-7648
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Country | US
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Telephone | 909-263-6540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D104060
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License Number State | CA
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