Provider Demographics
NPI:1205485794
Name:GREGORY PALMER DMD PC
Entity type:Organization
Organization Name:GREGORY PALMER DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-375-1777
Mailing Address - Street 1:9113 STELLA LINK RD STE 1
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3930
Mailing Address - Country:US
Mailing Address - Phone:713-375-1777
Mailing Address - Fax:832-383-0022
Practice Address - Street 1:9113 STELLA LINK RD STE 1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-3930
Practice Address - Country:US
Practice Address - Phone:713-375-1777
Practice Address - Fax:832-383-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1245548973OtherNPI TYPE 1
TX1245548973OtherGREGORY BERNARD PALMER