| Richard S. Powell D.m.d Inc | |
|
10044 Wolf Rd Suite D Grass Valley CA 95949-8193 | |
| (530) 268-8182 | |
| Not Available |
| Full Name | Richard S. Powell D.m.d Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10044 Wolf Rd, Grass Valley, California |
| Authorized Official Name and Position | Richard Stewart Powell (PRESIDENT) |
| Authorized Official Contact | 5302688182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard S. Powell D.m.d Inc 10044 Wolf Rd Suite D Grass Valley CA 95949-8193 Ph: (530) 268-8182 | Richard S. Powell D.m.d Inc 10044 Wolf Rd Suite D Grass Valley CA 95949-8193 Ph: (530) 268-8182 |
| NPI Number | 1235281072 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235281072 | NPI | - | NPPES |
| G9384501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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