Provider Demographics
NPI:1073759916
Name:MICHAEL P. POWERS, DDS, MS
Entity Type:Organization
Organization Name:MICHAEL P. POWERS, DDS, MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:330-678-9942
Mailing Address - Street 1:1930 SR 59
Mailing Address - Street 2:SUITE E
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4112
Mailing Address - Country:US
Mailing Address - Phone:330-678-9942
Mailing Address - Fax:330-678-3365
Practice Address - Street 1:1930 SR 59
Practice Address - Street 2:SUITE E
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4112
Practice Address - Country:US
Practice Address - Phone:330-678-9942
Practice Address - Fax:330-678-3365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-24
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty