Provider Demographics
NPI:1861791204
Name:POWERS, TNONEALYER GENEVA (DMD)
Entity type:Individual
Prefix:DR
First Name:TNONEALYER
Middle Name:GENEVA
Last Name:POWERS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:SICILY ISLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71368-0008
Mailing Address - Country:US
Mailing Address - Phone:318-389-9941
Mailing Address - Fax:318-389-9943
Practice Address - Street 1:710 CHISUM ST
Practice Address - Street 2:
Practice Address - City:SICILY ISLAND
Practice Address - State:LA
Practice Address - Zip Code:71368-4807
Practice Address - Country:US
Practice Address - Phone:318-389-9941
Practice Address - Fax:318-389-9943
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61391223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health