Healthcare Provider Details

I. General information

NPI: 1356105332
Provider Name (Legal Business Name): DUCHARME HOLDINGS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 VILLAGE BLVD STE 304
WEST PALM BEACH FL
33409-1973
US

IV. Provider business mailing address

603 VILLAGE BLVD STE 304
WEST PALM BEACH FL
33409-1973
US

V. Phone/Fax

Practice location:
  • Phone: 561-868-6618
  • Fax:
Mailing address:
  • Phone: 561-868-6618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: MONKIA DUCHARME
Title or Position: OWNER
Credential: O
Phone: 559-679-2044