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General NPI Number Information
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NPI Number | 1649436189
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Entity Type | Individual
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Provider Name | AUSTIN CHASE POWELL D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 1626 29TH CT S
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City | HOMEWOOD
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State | AL
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Zip | 35209-2442
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Country | US
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Telephone | 205-538-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 1626 29TH CT S
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City | HOMEWOOD
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State | AL
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Zip | 35209-2442
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Country | US
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Telephone | 205-538-3335
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 5627
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License Number State | AL
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