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General NPI Number Information
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NPI Number | 1326885211
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Entity Type | Organization
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Legal Business Name | PALM BEACH ORAL AND MAXILLOFACIAL SURGERY
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Dates
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Enumeration Date | 07/09/2024
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 1411 N FLAGLER DR STE 5200
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-3410
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Country | US
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Telephone | 561-833-6880
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Fax |
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Provider Business Mailing Address
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Address Line | 1402 DEL MAR DR
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City | POINCIANA
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State | FL
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Zip | 34759-6147
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Country | US
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Telephone | 513-833-3103
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Fax |
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | CHAD MATTHEW CURTIS
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Credential | DDS
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Telephone | 513-833-3103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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