Healthcare Provider Details

I. General information

NPI: 1003622598
Provider Name (Legal Business Name): HOBE SOUND DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8771 SE BRIDGE RD
HOBE SOUND FL
33455-5308
US

IV. Provider business mailing address

110 FOXFORD CT
JUPITER FL
33458-6508
US

V. Phone/Fax

Practice location:
  • Phone: 772-222-7844
  • Fax:
Mailing address:
  • Phone: 561-801-6309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MORGAN COAKLEY
Title or Position: OWNER
Credential: DMD
Phone: 561-801-6309