# DENTAL CORPORATION OF KYLE POULSEN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DENTAL OFFICE OF WINCHESTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467141804
- **Authorized official:** KEVIN POULSON DDS (OWNER)
- **Authorized official phone:** (951) 335-5169

## Contact information

- **Practice address:** 32897 WESTERN HILLS DR, SUITE 103, WINCHESTER, CA 92596
- **Practice address phone:** (951) 335-5169
- **Practice address fax:** (951) 213-4675
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2023
- **Last updated:** 05/02/2023