Provider Demographics
NPI:1407070246
Name:PALMER, LYNN ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ALAN
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 1:9090 GAYLORD ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2966
Mailing Address - Country:US
Mailing Address - Phone:713-464-1551
Mailing Address - Fax:713-464-1552
Practice Address - Street 1:9090 GAYLORD ST
Practice Address - Street 2:SUITE 208
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2966
Practice Address - Country:US
Practice Address - Phone:713-464-1551
Practice Address - Fax:713-464-1552
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX139321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice