Patrick Anthony Palma, DMD

Individual provider Active NPI Dentist · Mingo Junction, OH

NPI 1215025630 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1215025630
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
18889 (OH)
Practice address
620 Commercial St
Mingo Junction, OH 43938-1164
Phone
(740) 535-0600
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160217002693 OH Order and Referring Only - Dentist
Practitioner - Dentist
0749585479

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
18889OHMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18889 OH Yes

Addresses

Primary practice location

620 Commercial St
Mingo Junction, OH 43938-1164

Mailing address

620 Commercial St
Mingo Junction, OH 43938-1164
Phone (740) 535-0600

Other providers in Mingo Junction, OH

All providers in Mingo Junction, OH · Dentist in Ohio

Sources for this page

Verify at the official NPI Registry.