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General NPI Number Information
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NPI Number | 1265937072
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Entity Type | Individual
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Provider Name | BYRON CLIFTON PALMER DDS
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 06/05/2022
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Provider Practice Location Address
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Address Line | 1022 E STUART DR STE E
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City | GALAX
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State | VA
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Zip | 24333-2512
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Country | US
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Telephone | 276-236-4625
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Fax |
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Provider Business Mailing Address
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Address Line | 1022 E STUART DR STE E
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City | GALAX
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State | VA
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Zip | 24333-2512
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Country | US
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Telephone | 276-236-4925
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10840221-9922
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401417705
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License Number State | VA
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