Dr. Russell Powell, DDS
Dentist, General Practice in Caldwell, ID. Individual provider (NPI-1).
NPI number1154773869
StatusActive
Last updated in NPPESJul 6, 2016
Details
- NPI
- 1154773869
- Entity type
- Individual (NPI-1)
- Name
- Dr. Russell Powell
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 6, 2016
- Last updated
- Jul 6, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D-4762 | ID | Yes |
Practice location
329 E Logan StCaldwell, ID 83605-4863
Phone 208-459-3388 · Fax 208-453-9295
Mailing address
1807 S Crimson Rose AveBoise, ID 83709-8228
Phone 208-440-0885
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All 26 General Practice Dentistry providers in Caldwell · All 1,097 providers in Caldwell
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