| Ricky D. Powell, D.d.s., Llc | |
|
1945 Boone Villa Dr B Boonville MO 65233-2050 | |
| (660) 882-6452 | |
| Not Available |
| Full Name | Ricky D. Powell, D.d.s., Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1945 Boone Villa Dr, Boonville, Missouri |
| Authorized Official Name and Position | Ricky Daryl Powell (OWNER) |
| Authorized Official Contact | 6608826452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ricky D. Powell, D.d.s., Llc 1945 Boone Villa Dr B Boonville MO 65233-2050 Ph: (660) 882-6452 | Ricky D. Powell, D.d.s., Llc 1945 Boone Villa Dr B Boonville MO 65233-2050 Ph: (660) 882-6452 |
| NPI Number | 1639313752 |
|---|---|
| Provider Enumeration Date | 04/21/2009 |
| Last Update Date | 04/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639313752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13147 (Missouri) | Primary |
Scottkoerner, D.d.s.,p.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 Main St, Boonville, MO 65233 Phone: 660-882-7097 | |
Joseph T Kelly, Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1480 W Ashley Rd, Boonville, MO 65233 Phone: 660-882-7522 Fax: 660-882-9022 |