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General NPI Number Information
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NPI Number | 1679157853
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Entity Type | Organization
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Legal Business Name | NICOLE POWELL, DDS, PLLC
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 3206 LANGLEY DR
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City | SEARCY
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State | AR
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Zip | 72143-6020
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Country | US
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Telephone | 501-268-2000
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Fax | 501-268-2442
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Provider Business Mailing Address
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Address Line | 3206 LANGLEY DR
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City | SEARCY
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State | AR
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Zip | 72143-6020
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Country | US
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Telephone | 501-268-2000
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Fax | 501-268-2442
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MELISSA SPARKS
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Credential |
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Telephone | 501-268-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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