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General NPI Number Information
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NPI Number | 1750700563
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Entity Type | Organization
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Legal Business Name | PALMS DENTAL CARE PLLC
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 8918 LANTANA RD STE B
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City | LAKE WORTH
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State | FL
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Zip | 33467-6136
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Country | US
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Telephone | 772-341-2282
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Fax |
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Provider Business Mailing Address
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Address Line | 8918 LANTANA RD STE B
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City | LAKE WORTH
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State | FL
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Zip | 33467-6136
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KYLE KROMREY
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Credential | D.M.D.
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Telephone | 772-341-2282
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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 | DN19001
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License Number State | FL
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