Individual
DR. ROBERT COLIN POULSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S., J.D.
Contact information
Practice address
6800 MAIN ST, STE 206, DOWNERS GROVE, IL 60516-3493
(630) 852-1020
(630) 968-9229
Mailing address
6800 MAIN ST, STE 206, DOWNERS GROVE, IL 60516-3493
(630) 852-1020
(630) 968-9229
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
IL
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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