Healthcare Provider Details

I. General information

NPI: 1578620688
Provider Name (Legal Business Name): DONNA ANN PALMISANO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4324 VETERANS MEMORIAL BLVD SUITE 103
METAIRIE LA
70006-5445
US

IV. Provider business mailing address

4324 VETERANS MEMORIAL BOULEVARD SUITE 103
METAIRIE LA
70006
US

V. Phone/Fax

Practice location:
  • Phone: 504-885-2011
  • Fax:
Mailing address:
  • Phone: 504-885-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number4502
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: