Provider Demographics
NPI:1316032766
Name:HARWELL PALMER, DDS
Entity Type:Organization
Organization Name:HARWELL PALMER, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:HARWELL
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-997-5051
Mailing Address - Street 1:617 LONG DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379
Mailing Address - Country:US
Mailing Address - Phone:910-997-5051
Mailing Address - Fax:910-997-7942
Practice Address - Street 1:617 LONG DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4313
Practice Address - Country:US
Practice Address - Phone:910-997-5051
Practice Address - Fax:910-997-7942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC260653OtherUNITED CONCORDIA
NC96581OtherBCBS NC
NC8996581Medicaid