MEDICARE: DR. EUGENE HARWELL PALMER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	5321	NC

General Provider Information

NPI Number	:	1578595401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENE HARWELL PALMER D.D.S.

Provider Business Mailing Address
First Line	:	617 S LONG DR
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4313
Country	:	US
Telephone Number	:	910-997-5051
Fax Number	:	910-997-7942

Provider Business Practice Location Address
First Line	:	617 S LONG DR
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4313
Country	:	US
Telephone Number	:	910-997-5051
Fax Number	:	910-997-7942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	07/08/2007

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