| Profiles Ii Oral And Facial Surgery ,pllc | |
|
2560 Rca Blvd Suite 102 Palm Beach Gardens FL 33410-3338 | |
| (561) 622-9065 | |
| Not Available |
| Full Name | Profiles Ii Oral And Facial Surgery ,pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2560 Rca Blvd, Palm Beach Gardens, Florida |
| Authorized Official Name and Position | Makepeace Charles (ORAL SURGEON) |
| Authorized Official Contact | 5616229065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Profiles Ii Oral And Facial Surgery ,pllc 2560 Rca Blvd Suite 102 Palm Beach Gardens FL 33410-3338 Ph: (561) 622-9065 | Profiles Ii Oral And Facial Surgery ,pllc 2560 Rca Blvd Suite 102 Palm Beach Gardens FL 33410-3338 Ph: (561) 622-9065 |
| NPI Number | 1477837011 |
|---|---|
| Provider Enumeration Date | 09/30/2011 |
| Last Update Date | 07/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477837011 | NPI | - | NPPES |
| 003758600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Florida) | Primary |
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