Provider Demographics
NPI:1942692173
Name:MCINNES PALMER ORTHODONTICS
Entity Type:Organization
Organization Name:MCINNES PALMER ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:MCINNES
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-823-1900
Mailing Address - Street 1:8322 BELLONA AVE
Mailing Address - Street 2:310
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2065
Mailing Address - Country:US
Mailing Address - Phone:410-823-1900
Mailing Address - Fax:410-823-5460
Practice Address - Street 1:8322 BELLONA AVE
Practice Address - Street 2:310
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2065
Practice Address - Country:US
Practice Address - Phone:410-823-1900
Practice Address - Fax:410-823-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14686261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental