Provider Demographics
NPI:1619181732
Name:POWERS, JOSEPH J (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
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 1:35050 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-3606
Mailing Address - Country:US
Mailing Address - Phone:586-725-4311
Mailing Address - Fax:
Practice Address - Street 1:35050 23 MILE RD
Practice Address - Street 2:
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-3606
Practice Address - Country:US
Practice Address - Phone:586-725-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI122071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice