Provider Demographics
NPI:1750474698
Name:PALERMO, LUIGI ARTURO (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUIGI
Middle Name:ARTURO
Last Name:PALERMO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-1543
Mailing Address - Country:US
Mailing Address - Phone:508-842-3433
Mailing Address - Fax:978-874-5428
Practice Address - Street 1:16 WYMAN RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473-1601
Practice Address - Country:US
Practice Address - Phone:978-874-7363
Practice Address - Fax:978-874-5428
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA190571223G0001X
MA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA976434OtherUCCI
MAX11527OtherBC/BS OF MA