MEDICARE: ROSANNE M PALERMO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS027193L	PA

General Provider Information

NPI Number	:	1346330131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSANNE M PALERMO DMD

Provider Business Mailing Address
First Line	:	3437 WEST LAKE RD
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505-3661
Country	:	US
Telephone Number	:	814-833-3001
Fax Number	:	814-833-4886

Provider Business Practice Location Address
First Line	:	3437 WEST LAKE RD
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505-3661
Country	:	US
Telephone Number	:	814-833-3001
Fax Number	:	814-833-4886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	04/25/2016

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Directions to “ ROSANNE M PALERMO DMD” Practice Location

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