Provider Demographics
NPI:1033646708
Name:DRS. PALUMBO & PALUMBO, LLC
Entity Type:Organization
Organization Name:DRS. PALUMBO & PALUMBO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:PALUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-292-6900
Mailing Address - Street 1:10905 FORT WASHINGTON RD
Mailing Address - Street 2:STE 214
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5843
Mailing Address - Country:US
Mailing Address - Phone:301-292-6900
Mailing Address - Fax:301-292-3993
Practice Address - Street 1:10905 FORT WASHINGTON RD
Practice Address - Street 2:STE 214
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5843
Practice Address - Country:US
Practice Address - Phone:301-292-6900
Practice Address - Fax:301-292-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD106611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty