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1407970916
KEITH J POULSEN
SALT LAKE CITY, UT
NPI
1407970916
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist Pediatric Dentistry
(Licence: UT 134901)
Enumeration Date
2007-03-19
Last Update Date
2007-07-08
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
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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
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