Provider Demographics
NPI:1881721785
Name:PALACIOS, PIERO G (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:PIERO
Middle Name:G
Last Name:PALACIOS
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:1111 BRICKELL BAY DR
Mailing Address - Street 2:APARTMENT 409
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2950
Mailing Address - Country:US
Mailing Address - Phone:860-223-7014
Mailing Address - Fax:305-271-3640
Practice Address - Street 1:8740 N KENDALL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2212
Practice Address - Country:US
Practice Address - Phone:305-274-3113
Practice Address - Fax:305-271-3640
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLDN174431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics