Provider Demographics
NPI:1326628926
Name:PALMER, SEAN THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:THOMAS
Last Name:PALMER
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 1:96 AYRAULT DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1927
Mailing Address - Country:US
Mailing Address - Phone:801-814-5724
Mailing Address - Fax:
Practice Address - Street 1:606 FISHER ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39534-2513
Practice Address - Country:US
Practice Address - Phone:228-376-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program