Healthcare Provider Details

I. General information

NPI: 1841141421
Provider Name (Legal Business Name): NEXTSTEP SMILES PBG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 BURNS RD STE 214
PALM BEACH GARDENS FL
33410-4312
US

IV. Provider business mailing address

3365 BURNS RD STE 214
PALM BEACH GARDENS FL
33410-4312
US

V. Phone/Fax

Practice location:
  • Phone: 561-679-6544
  • Fax:
Mailing address:
  • Phone: 561-679-6544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLES ETHEREDGE
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 561-704-7941