MEDICARE: PALM & PANEK DDS PC

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number	:	1437206745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM & PANEK DDS PC

Provider Business Mailing Address
First Line	:	158 MARCELL DR NE
Second Line	:	SUITE B
City	:	ROCKFORD
State	:	MI
Zip	:	49341-1390
Country	:	US
Telephone Number	:	616-866-4200
Fax Number	:	616-866-0320

Provider Business Practice Location Address
First Line	:	158 MARCELL DR NE
Second Line	:	SUITE B
City	:	ROCKFORD
State	:	MI
Zip	:	49341-1362
Country	:	US
Telephone Number	:	616-866-4200
Fax Number	:	616-866-0320

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	SAMANTHA JO HANES
Credential	:
Telephone Number	:	616-361-7327

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	11/02/2021

Similar Medicare Providers

1427020023 — DR. GARY J FOWLE OD
Practice Location Address:

120 MARCELL DR NE , SUITE A
ROCKFORD, MI
49341-1362

Practice Phone: 616-866-0140
Practice Fax: 616-866-8694

1215343124 — DR. ANDREW FOWLE O.D.
Practice Location Address:

120 MARCELL DR NE , SUITE A
ROCKFORD, MI
49341-1362

Practice Phone: 616-866-0140
Practice Fax:

1144146317 — RESILIENCE OSTEOPATHY P.L.L.C.
Practice Location Address:

120 MARCELL DR NE STE C
ROCKFORD, MI
49341-1362

Practice Phone: 231-878-6194
Practice Fax:

1871421347 — ELISE LOVISA COUTURIER
Practice Location Address:

120 MARCELL DR NE STE A
ROCKFORD, MI
49341-1362

Practice Phone: 616-866-0140
Practice Fax: 616-866-8694

1851433999 — DR. ROYCE G NEWMAN D.C.
Practice Location Address:

120 MARCELL DR NE , SUITE B
ROCKFORD, MI
49341-1362

Practice Phone: 616-866-0150
Practice Fax: 616-866-7771

1780888081 — FOWLE EYECARE ASSOCIATES PLC
Practice Location Address:

120 MARCELL DR NE , SUITE A
ROCKFORD, MI
49341-1362

Practice Phone: 616-866-0140
Practice Fax: 616-866-8694

Directions to “PALM & PANEK DDS PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.