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General NPI Number Information
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NPI Number | 1962190561
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Entity Type | Organization
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Legal Business Name | JUSTIN ASAEL PALMER DMD PLLC
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 1075 E RIGGS RD STE 2
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City | CHANDLER
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State | AZ
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Zip | 85249-3685
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Country | US
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Telephone | 602-748-8285
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Fax |
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Provider Business Mailing Address
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Address Line | 1075 E RIGGS RD STE 2
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City | CHANDLER
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State | AZ
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Zip | 85249-3685
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Country | US
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Telephone | 602-748-8285
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN PALMER
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Credential | DMD
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Telephone | 602-748-8285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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