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NPI Code Detail

MEDICARE: DR. JEREMY TAYLOR POWERS DMD

MEDICARE: DR. JEREMY TAYLOR POWERS DMD
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 Dentistry101349CA

General Provider Information

NPI Number : 1790206423
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEREMY TAYLOR POWERS DMD
Provider Business Mailing Address
First Line : 29950 HAUN RD STE 302
Second Line :
City : MENIFEE
State : CA
Zip : 92586-6527
Country : US
Telephone Number : 951-679-1667
Fax Number :
Provider Business Practice Location Address
First Line : 29950 HAUN RD STE 302
Second Line :
City : MENIFEE
State : CA
Zip : 92586-6527
Country : US
Telephone Number : 951-679-1667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2017
Last Update Date : 07/03/2017

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