Individual
DR. CARL PETER PALMBLAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14 N COUNTRY RD, PORT JEFFERSON, NY 11777-2116
(631) 473-0052
(631) 474-9066
Mailing address
14 N COUNTRY RD, PORT JEFFERSON, NY 11777-2116
(631) 473-0052
(631) 474-9066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
041184
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01043241
—
NY
Enumeration date
06/01/2005
Last updated
03/07/2023
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