Provider Demographics
NPI:1861470015
Name:POWELL, JONATHAN FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:FRANK
Last Name:POWELL
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 1:301 S 9TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3448
Mailing Address - Country:US
Mailing Address - Phone:281-341-6644
Mailing Address - Fax:281-341-5455
Practice Address - Street 1:301 S 9TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3448
Practice Address - Country:US
Practice Address - Phone:281-341-6644
Practice Address - Fax:281-341-5455
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice