Provider Demographics
NPI:1265937072
Name:PALMER, BYRON CLIFTON (DDS)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:CLIFTON
Last Name:PALMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 E STUART DR STE E
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2512
Mailing Address - Country:US
Mailing Address - Phone:276-236-4925
Mailing Address - Fax:
Practice Address - Street 1:1022 E STUART DR STE E
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2512
Practice Address - Country:US
Practice Address - Phone:276-236-4625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10840221-99221223G0001X
VA04014177051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice