Provider Demographics
NPI:1104027507
Name:POWERS, DARRELL LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:LEE
Last Name:POWERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1060
Mailing Address - Street 2:
Mailing Address - City:ROBBINS
Mailing Address - State:NC
Mailing Address - Zip Code:27325
Mailing Address - Country:US
Mailing Address - Phone:910-948-2555
Mailing Address - Fax:910-948-4524
Practice Address - Street 1:300 MIDDLETON ST
Practice Address - Street 2:
Practice Address - City:ROBBINS
Practice Address - State:NC
Practice Address - Zip Code:27325
Practice Address - Country:US
Practice Address - Phone:910-948-2555
Practice Address - Fax:910-948-2555
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4526122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist