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Individual

ROBERT BARTHOLOMEW POULARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4566 OKLAHOMA AVE, BLDG 2100, FORT LEONARD WOOD, MO 65473-1638
(573) 596-2903
Mailing address
4566 OKLAHOMA AVE, BLDG 2100, FORT LEONARD WOOD, MO 65473-1638
(573) 596-2903

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary

Other

Enumeration date
07/12/2016
Last updated
07/12/2016
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