Provider Demographics
NPI:1578789632
Name:POELMAN, DAVID C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:POELMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 S 163RD ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-9475
Mailing Address - Country:US
Mailing Address - Phone:480-203-6415
Mailing Address - Fax:
Practice Address - Street 1:1070 E RAY RD
Practice Address - Street 2:SUITE 7
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1771
Practice Address - Country:US
Practice Address - Phone:480-792-6880
Practice Address - Fax:480-792-6870
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ05638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist