Provider Demographics
NPI:1720601321
Name:PALMER, MARGARET MARY ELLEN (DMD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY ELLEN
Last Name:PALMER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 JAMECO MILL RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8215
Mailing Address - Country:US
Mailing Address - Phone:207-671-7760
Mailing Address - Fax:
Practice Address - Street 1:80 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2203
Practice Address - Country:US
Practice Address - Phone:207-344-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN4788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist