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General NPI Number Information
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NPI Number | 1376778084
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Entity Type | Individual
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Provider Name | ERIC PALACIOS DDS
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Gender | Male
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 1021 HEALTH PARK CIR
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City | MOORE HAVEN
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State | FL
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Zip | 33471-6206
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Country | US
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Telephone | 863-946-0405
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Fax | 863-946-0145
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Provider Business Mailing Address
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Address Line | 4450 S TIFFANY DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3241
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Country | US
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Telephone | 561-844-9443
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Fax | 561-844-1013
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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 | DN 18121
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License Number State | FL
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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 | 10373
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License Number State | CO
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