Provider Demographics
NPI:1780680447
Name:POWELL, WILLIAM KENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KENT
Last Name:POWELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:W.
Other - Middle Name:KENT
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 474
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024-0474
Mailing Address - Country:US
Mailing Address - Phone:816-637-6021
Mailing Address - Fax:816-637-6022
Practice Address - Street 1:1911 W JESSE JAMES RD
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-1805
Practice Address - Country:US
Practice Address - Phone:816-637-6021
Practice Address - Fax:816-637-6022
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO120961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice