MEDICARE: JOHN P POOVEY DMD PC

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
1	1223G0001X	General Practice Dentistry	9033	CO

General Provider Information

NPI Number	:	1447344312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN P POOVEY DMD PC

Provider Business Mailing Address
First Line	:	2412 PATTERSON RD STE 7
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1259
Country	:	US
Telephone Number	:	970-243-2025
Fax Number	:	970-243-2027

Provider Business Practice Location Address
First Line	:	2412 PATTERSON RD STE 7
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1259
Country	:	US
Telephone Number	:	970-243-2025
Fax Number	:	970-243-2027

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JOHN PENNINGTON POOVEY
Credential	:	DMD
Telephone Number	:	970-243-2025

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	05/07/2026

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