Individual
DR. ROBERT A. PALMER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6150 LINE AVE, SHREVEPORT, LA 71106-2051
(318) 868-5726
(318) 868-7546
Mailing address
6150 LINE AVE, SHREVEPORT, LA 71106-2051
(318) 868-5726
(318) 868-7546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3997
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1839973
—
LA
01
—
192707
UNITED CONCORDIA
LA
01
—
D1259
BLUE CROSS BLUE SHIELD
LA
Enumeration date
04/17/2007
Last updated
07/08/2007
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