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NPI Code Detail

MEDICARE: ROBERT S PALMER DDS PC

MEDICARE: ROBERT S PALMER 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
1261QD0000XDental Clinic/Center72615429922UT

General Provider Information

NPI Number : 1457606188
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT S PALMER DDS PC
Provider Business Mailing Address
First Line : 223 S 700 E
Second Line : STE 3
City : SALT LAKE CITY
State : UT
Zip : 84102-2171
Country : US
Telephone Number : 801-355-6997
Fax Number :
Provider Business Practice Location Address
First Line : 223 S 700 E
Second Line : STE 3
City : SALT LAKE CITY
State : UT
Zip : 84102-2171
Country : US
Telephone Number : 801-355-6997
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ROBERT S PALMER
Credential : DDS
Telephone Number : 801-721-1310
Provider Enumeration Date : 07/18/2012
Last Update Date : 07/18/2012

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