Individual
TYFFANI TYNNEIL PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7451 N BEACH ST STE 140, FORT WORTH, TX 76137-5160
(817) 847-7001
(817) 847-7009
Mailing address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 795-8100
(956) 718-6294
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27199
TX
1223P0221X
Pediatric Dentistry
Primary
27199
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27199
TEXAS DENTAL LICENSE
TX
Enumeration date
07/27/2011
Last updated
10/19/2021
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