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Individual
CASSI POULSEN
Active
Individual
CASSI POULSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417274
VA
122300000X
Dentist
DS042444
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568019479
MILITARY
VA
05
—
1568019479
—
VA
Enumeration date
08/26/2019
Last updated
02/06/2026
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