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Individual

DR. RACHEL ANN POULSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
2006 N MAIN ST, MISHAWAKA, IN 46545-5612
(574) 259-8571
Mailing address
2006 N MAIN ST, MISHAWAKA, IN 46545-5612
(574) 259-8571

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011310A
IN

Other

Enumeration date
07/05/2009
Last updated
07/12/2010
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