Provider Demographics
NPI:1033278221
Name:PALANK, GARY PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:PETER
Last Name:PALANK
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 1:314 NORTH POTOMAC STREET
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-3895
Mailing Address - Country:US
Mailing Address - Phone:301-739-0100
Mailing Address - Fax:301-739-6701
Practice Address - Street 1:314 NORTH POTOMAC STREET
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-3895
Practice Address - Country:US
Practice Address - Phone:301-739-0100
Practice Address - Fax:301-739-6701
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5769122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist