Provider Demographics
NPI:1235332073
Name:PALUMBO, PAT (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAT
Middle Name:
Last Name:PALUMBO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10905 FORT WASHINGTON RD
Mailing Address - Street 2:SUITE 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:SUITE 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
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD106611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery