Provider Demographics
NPI:1033224399
Name:GROUP DENTAL OF THE PALM BEACHES INC.
Entity type:Organization
Organization Name:GROUP DENTAL OF THE PALM BEACHES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-833-5474
Mailing Address - Street 1:2601 NORTH FLAGLER DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407
Mailing Address - Country:US
Mailing Address - Phone:561-833-5474
Mailing Address - Fax:561-833-0490
Practice Address - Street 1:2601 N FLAGLER DR STE 101
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-5542
Practice Address - Country:US
Practice Address - Phone:561-833-5474
Practice Address - Fax:561-833-0490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty