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NPI Code Detail

MEDICARE: DR. KENNETH SENIOR POWELL II D.D.S.

MEDICARE:  DR. KENNETH SENIOR POWELL II D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry011987MO

General Provider Information

NPI Number : 1326125782
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH SENIOR POWELL II D.D.S.
Provider Business Mailing Address
First Line : 3403 UNION BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63115-1127
Country : US
Telephone Number : 314-381-1556
Fax Number : 314-381-4599
Provider Business Practice Location Address
First Line : 3403 UNION BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63115-1127
Country : US
Telephone Number : 314-381-1556
Fax Number : 314-381-4599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ DR. KENNETH SENIOR POWELL II D.D.S.” Practice Location

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