Individual
DR. KENNETH PALM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
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 05446-8800
(802) 655-5308
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
01237
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005081
—
VT
01
—
412187837
TAX IDENTIFICATION NUMBER
VT
Enumeration date
04/04/2007
Last updated
12/15/2011
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