KEITH J POULSEN

SALT LAKE CITY, UT
NPI1407970916
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: UT  134901)
Enumeration Date2007-03-19
Last Update Date2007-07-08
Business Address
Dr. KEITH J POULSEN D.D.S
7138 HIGHLAND DR SUITE 216
SALT LAKE CITY, UT 84121-3757
Phone number: 801-944-0668
Mailing Address
Dr. KEITH J POULSEN D.D.S
7138 HIGHLAND DR SUITE 216
SALT LAKE CITY, UT 84121-3757
Phone number: 801-944-0668