Provider Demographics
NPI:1477755700
Name:POWELL, PHILLIP B (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:B
Last Name:POWELL
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1516 COLEMAN RD
Mailing Address - Street 2:STE 208
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-3809
Mailing Address - Country:US
Mailing Address - Phone:865-588-1644
Mailing Address - Fax:865-602-2450
Practice Address - Street 1:1516 COLEMAN RD
Practice Address - Street 2:STE 208
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-3809
Practice Address - Country:US
Practice Address - Phone:865-588-1644
Practice Address - Fax:865-602-2450
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNDS00000022831223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223P0221XDental ProvidersDentistPediatric Dentistry
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics