Provider Demographics
NPI:1144464603
Name:POWER, REBECA ELIZABETH (DMD)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:ELIZABETH
Last Name:POWER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 E OCEAN BLVD STE 216B
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3501
Mailing Address - Country:US
Mailing Address - Phone:772-223-1539
Mailing Address - Fax:772-223-4545
Practice Address - Street 1:3251 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4457
Practice Address - Country:US
Practice Address - Phone:772-692-1447
Practice Address - Fax:772-692-3551
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN168171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics