Stephen Goodwin Powell, DDS
Individual provider Active NPI General Practice Dentistry · Willard, MO
NPI 1942398326 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1942398326
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 011706 (MO)
- Practice address
- 304 E Jackson St
Willard, MO 65781-9333 - Phone
- (417) 742-2555
- Fax
- (417) 742-4400
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011706 | MO | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 011706 | MO | Yes |
Addresses
Primary practice location
304 E Jackson St
Willard, MO 65781-9333
Mailing address
304 E Jackson St
Willard, MO 65781-9333
Phone (417) 742-2555
Other providers in Willard, MO
- Katelyn Nash
- Justin Tom Nguyen
- Dakota Lager Pearce
- Soleya Abigail Pippin
- Nicole Pounds
- Regional Services
- Alice R. Riedel
- Erin Kathleen Rippee
- Kristen Leigh Roberts
- Damon Charles Robison
All providers in Willard, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.