Provider Demographics
NPI:1003465477
Name:PALMER, MEGHAN MCINNES (DDS)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MCINNES
Last Name:PALMER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8322 BELLONA AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2077
Mailing Address - Country:US
Mailing Address - Phone:410-823-1900
Mailing Address - Fax:410-823-5460
Practice Address - Street 1:8322 BELLONA AVE STE 310
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2077
Practice Address - Country:US
Practice Address - Phone:410-823-1900
Practice Address - Fax:410-823-5460
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146861223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty