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General NPI Number Information
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NPI Number | 1730885914
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER POWELL, DDS PEDIATRIC DENTISTRY, PLLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 2360 76TH ST SW STE A
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City | BYRON CENTER
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State | MI
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Zip | 49315-8524
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Country | US
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Telephone | 616-730-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 8866 CASCADE RD SE
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City | ADA
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State | MI
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Zip | 49301-8321
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Country | US
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Telephone | 616-730-4111
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Fax | 616-730-4115
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER POWELL
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Credential | DDS
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Telephone | 616-730-4111
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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 |
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License Number State |
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