Healthcare Provider Details

I. General information

NPI: 1104267244
Provider Name (Legal Business Name): CHASE DENTAL SLEEPCARE OF PALM BEACH GARDENS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2013
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 RCA BLVD #105
PALM BEACH GARDENS FL
33410-3338
US

IV. Provider business mailing address

2560 RCA BLVD #105
PALM BEACH GARDENS FL
33410-3338
US

V. Phone/Fax

Practice location:
  • Phone: 561-799-5000
  • Fax:
Mailing address:
  • Phone: 561-799-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN12464
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID M SKOPP
Title or Position: MGR
Credential: D.D.S.
Phone: 561-799-5000