Organization
PROFILES II ORAL AND FACIAL SURGERY ,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAKEPEACE CHARLES DDS (ORAL SURGEON)
(561) 622-9065
Entity
Organization
Contact information
Practice address
2560 RCA BLVD, SUITE 102, PALM BEACH GARDENS, FL 33410-3338
(561) 622-9065
Mailing address
2560 RCA BLVD, SUITE 102, PALM BEACH GARDENS, FL 33410-3338
(561) 622-9065
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003758600
—
FL
Enumeration date
09/30/2011
Last updated
07/25/2016
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