Healthcare Provider Details
I. General information
NPI: 1033224399
Provider Name (Legal Business Name): GROUP DENTAL OF THE PALM BEACHES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2601 N FLAGLER DR STE 101
WEST PALM BEACH FL
33407-5542
US
IV. Provider business mailing address
2601 NORTH FLAGLER DRIVE SUITE 101
WEST PALM BEACH FL
33407
US
V. Phone/Fax
- Phone: 561-833-5474
- Fax: 561-833-0490
- Phone: 561-833-5474
- Fax: 561-833-0490
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
P
BROWN
Title or Position: VICE PRESIDENT
Credential: DMD
Phone: 561-833-5474