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Individual

DR. TRACI PAULSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
923 6TH AVE, DE WITT, IA 52742-1330
(563) 659-9500
Mailing address
923 6TH AVE, DE WITT, IA 52742-1330
(563) 659-9500

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07800
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0264440
IA
Enumeration date
05/21/2007
Last updated
07/22/2008
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