Individual
DR. MARK STEPHEN PALMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
204 MCCOLLUM DR, SUITE 103, LARAMIE, WY 82070-5103
(307) 745-5055
Mailing address
PO BOX 987, LARAMIE, WY 82073-0987
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6937
CO
122300000X
Dentist
Primary
893
WY
Other
Enumeration date
02/23/2011
Last updated
02/23/2011
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