Provider Demographics
NPI:1447382528
Name:PALMER, DAVID T (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
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 1:111 CHRISTIE DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-5575
Mailing Address - Country:US
Mailing Address - Phone:936-637-3788
Mailing Address - Fax:936-637-3810
Practice Address - Street 1:111 CHRISTIE DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-5575
Practice Address - Country:US
Practice Address - Phone:936-637-3788
Practice Address - Fax:936-637-3810
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX154431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice