Individual
DR. WENDALL PETER POULSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4040 BLACKBURN LN, SUITE 180, BURTONSVILLE, MD 20866-6136
(301) 421-9001
(301) 421-9772
Mailing address
4040 BLACKBURN LN, SUITE 180, BURTONSVILLE, MD 20866-6136
(301) 421-9001
(301) 421-9772
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
09165
MD
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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