Provider Demographics
NPI:1316043789
Name:PALM, WILLIAM M (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:PALM
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 1:26789 WOODWARD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1335
Mailing Address - Country:US
Mailing Address - Phone:248-398-6046
Mailing Address - Fax:248-398-6850
Practice Address - Street 1:26789 WOODWARD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1335
Practice Address - Country:US
Practice Address - Phone:248-398-6046
Practice Address - Fax:248-398-6850
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010170541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice