Dallin Palmer, DMD

Individual provider Active NPI Dentist · Mapleton, UT

NPI 1366842981 · NPPES record last updated Feb 11, 2016

Key facts

NPI
1366842981
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
9461687 (UT)
Practice address
425 N Main St
Mapleton, UT 84664-3410
Phone
(801) 491-8191
Fax
(801) 491-8191
NPI assigned
Sep 2, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
30182TXMDDentist
9461687UTMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30182 TX
Dentist 122300000X 9461687 UT Yes

Addresses

Primary practice location

425 N Main St
Mapleton, UT 84664-3410

Mailing address

1843 E 160 S
Spanish Fork, UT 84660-5587
Phone (801) 634-1996

Other providers in Mapleton, UT

All providers in Mapleton, UT · Dentist in Utah

Sources for this page

Verify at the official NPI Registry.