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General NPI Number Information
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NPI Number | 1427943851
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Entity Type | Individual
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Provider Name | ANDRES EDUARDO PALACIOS DMD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 432 BUTTERFIELD RD
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City | CHINO VALLEY
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State | AZ
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Zip | 86323-5613
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Country | US
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Telephone | 928-636-1565
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Fax |
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Provider Business Mailing Address
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Address Line | 1476 VARSITY DR
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City | PRESCOTT
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State | AZ
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Zip | 86301-7846
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Country | US
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Telephone | 956-624-3767
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D012526
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License Number State | AZ
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