Provider Demographics
NPI:1043471295
Name:PALTE, ERIC JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOSEPH
Last Name:PALTE
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 1:1722 GUTHRIE AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3546
Mailing Address - Country:US
Mailing Address - Phone:810-241-5292
Mailing Address - Fax:
Practice Address - Street 1:579TH DENTAL SQUADRON
Practice Address - Street 2:
Practice Address - City:BOLLING AFB
Practice Address - State:DC
Practice Address - Zip Code:20322
Practice Address - Country:US
Practice Address - Phone:810-241-5292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019866122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist