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Individual

GLENN R POULESON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
6800 MAIN ST, APEX ENDODONTICS #205, DOWNERS GROVE, IL 60516
(630) 964-4499
(630) 964-4523
Mailing address
6800 MAIN ST, APEX ENDODONTICS #205, DOWNERS GROVE, IL 60516
(630) 964-4499
(630) 964-4523

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
021-001347
IL

Other

Enumeration date
05/13/2008
Last updated
05/13/2008
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