Healthcare Provider Details

I. General information

NPI: 1285542639
Provider Name (Legal Business Name): LOUIS G PALACIOS DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 GRANVILLE DR
SILVER SPRING MD
20901-3103
US

IV. Provider business mailing address

303 GRANVILLE DR
SILVER SPRING MD
20901-3103
US

V. Phone/Fax

Practice location:
  • Phone: 301-589-5877
  • Fax:
Mailing address:
  • Phone: 301-589-5877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LOUIS PALACIOS
Title or Position: DENTIST/OWNER
Credential:
Phone: 301-589-5877