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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