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General NPI Number Information
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NPI Number | 1285736413
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Entity Type | Organization
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Legal Business Name | PAUL B. PALMER D.D.S., INC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 12202 W WASHINGTON BL
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City | LOS ANGELES
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State | CA
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Zip | 90066
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Country | US
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Telephone | 310-915-9797
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Fax | 310-915-9739
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Provider Business Mailing Address
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Address Line | 12202 W WASHINGTON BL
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City | LOS ANGELES
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State | CA
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Zip | 90066
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Country | US
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Telephone | 310-915-9797
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Fax | 310-915-9739
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL B PALMER
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Credential | DDS
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Telephone | 310-915-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 28603
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License Number State | CA
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