Provider Demographics
NPI:1053454694
Name:PALAZZOLO, SALVATORE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:
Last Name:PALAZZOLO
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 1:307 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3013
Mailing Address - Country:US
Mailing Address - Phone:516-678-9072
Mailing Address - Fax:
Practice Address - Street 1:307 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3013
Practice Address - Country:US
Practice Address - Phone:516-678-9072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040710-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist