Provider Demographics
NPI:1215960349
Name:CLOCKWORKS DENTAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:CLOCKWORKS DENTAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-323-6520
Mailing Address - Street 1:1590 MEDICAL DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3247
Mailing Address - Country:US
Mailing Address - Phone:610-323-6520
Mailing Address - Fax:610-327-0521
Practice Address - Street 1:1590 MEDICAL DR
Practice Address - Street 2:SUITE D
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3247
Practice Address - Country:US
Practice Address - Phone:610-323-6520
Practice Address - Fax:610-327-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028301L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty