Provider Demographics
NPI:1194755637
Name:PALACIOS, ROSARIO PATRICIA (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:ROSARIO
Middle Name:PATRICIA
Last Name:PALACIOS
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1800 116TH AVE NE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3043
Mailing Address - Country:US
Mailing Address - Phone:425-688-7840
Mailing Address - Fax:425-452-1537
Practice Address - Street 1:1800 116TH AVE NE
Practice Address - Street 2:SUITE 203
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3043
Practice Address - Country:US
Practice Address - Phone:425-688-7840
Practice Address - Fax:425-452-1537
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000104361223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics