Provider Demographics
NPI:1912095803
Name:POWELL, WESLEY DEAN (DDS, M S)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:DEAN
Last Name:POWELL
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Gender:M
Credentials:DDS, M S
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Mailing Address - Street 1:2244 HENDERSON MILL RD NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2760
Mailing Address - Country:US
Mailing Address - Phone:770-934-5900
Mailing Address - Fax:770-493-6599
Practice Address - Street 1:2244 HENDERSON MILL RD NE
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2760
Practice Address - Country:US
Practice Address - Phone:770-934-5900
Practice Address - Fax:770-493-6599
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA123921223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry