Provider Demographics
NPI:1497379564
Name:DENVER J. PALMER, D.M.D., P.C.
Entity Type:Organization
Organization Name:DENVER J. PALMER, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DENVER
Authorized Official - Middle Name:J
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:719-649-4459
Mailing Address - Street 1:6852 E BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-3706
Mailing Address - Country:US
Mailing Address - Phone:480-981-1755
Mailing Address - Fax:
Practice Address - Street 1:6852 E BROWN RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-3706
Practice Address - Country:US
Practice Address - Phone:719-649-4459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental