Individual
DR. BRIAN POULSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2166 MAGNOLIA AVE, BUENA VISTA, VA 24416-3112
(540) 261-2284
Mailing address
2166 MAGNOLIA AVE, BUENA VISTA, VA 24416-3112
(540) 261-2284
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
041414578
VA
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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