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Organization
DR. KENNETH PALM
Active
Organization
DR. KENNETH PALM
Active
Other names
Colchester Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH PALM D.D.S. (DENTIST)
(802) 655-5308
Entity
Organization
Contact information
Practice address
106 HIGH POINT CTR, SUITE 100, COLCHESTER, VT 05446-5861
(802) 655-5308
(802) 655-5715
Mailing address
106 HIGH POINT CTR, SUITE 100, COLCHESTER, VT 05446-5861
(802) 655-5308
(802) 655-5715
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
01237
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01237
STATE DENTAL LICENSE
VT
05
—
1005081
—
VT
Enumeration date
05/09/2007
Last updated
07/17/2008
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