Provider Demographics
NPI:1700141058
Name:PALMER-ESPANOL, MICHELLE A (DMD, MS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:PALMER-ESPANOL
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10075 S JOG RD STE 301
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3537
Mailing Address - Country:US
Mailing Address - Phone:561-732-7666
Mailing Address - Fax:561-731-2300
Practice Address - Street 1:10075 S JOG RD STE 301
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3537
Practice Address - Country:US
Practice Address - Phone:561-732-7666
Practice Address - Fax:561-731-2300
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL192461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics