Provider Demographics
NPI:1346263696
Name:DR. STEPHEN G. POWELL, DR. ERNEST E. CURRY, DR. JAMES C JORDAN DDS LLC
Entity Type:Organization
Organization Name:DR. STEPHEN G. POWELL, DR. ERNEST E. CURRY, DR. JAMES C JORDAN DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:GOODWIN
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-742-2555
Mailing Address - Street 1:403 EAST JACKSON
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:MO
Mailing Address - Zip Code:65781-0488
Mailing Address - Country:US
Mailing Address - Phone:417-742-4400
Mailing Address - Fax:
Practice Address - Street 1:403 E JACKSON
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:MO
Practice Address - Zip Code:65781-0488
Practice Address - Country:US
Practice Address - Phone:417-742-2555
Practice Address - Fax:417-742-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty