Provider Demographics
NPI:1508041336
Name:PALMER, BILL ARTHUR (DDS)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:ARTHUR
Last Name:PALMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:ARTHUR
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1843 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-9243
Mailing Address - Country:US
Mailing Address - Phone:419-599-5545
Mailing Address - Fax:419-592-6400
Practice Address - Street 1:1843 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-9243
Practice Address - Country:US
Practice Address - Phone:419-599-5545
Practice Address - Fax:419-592-6400
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300125311223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0073049Medicaid