Organization
PROFILES II ORAL AND FACIAL SURGERY ,PLLC
Active
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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