Organization · NPI-2

Charles H Etheredge Dmd PA

Dentist · Palm Beach Gardens, FL

NPI number1013735729
StatusActive
Last updated in NPPESOct 1, 2024

Details

NPI
1013735729
Entity type
Organization (NPI-2)
Legal business name
Charles H Etheredge Dmd PA
Organization subpart
No
Enumeration date
Oct 1, 2024
Certification date
Sep 24, 2024
Last updated
Oct 1, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist––Yes
332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment––

Other names

  • Restassured Sleep Centers (Doing Business As)

Practice location

3365 Burns Rd Ste 212
Palm Beach Gardens, FL 33410-4302

Phone 561-627-9056 · Fax 561-625-0910

Mailing address

3365 Burns Rd Ste 212
Palm Beach Gardens, FL 33410-4302

Phone 561-627-9056 · Fax 561-625-0910

Authorized official

Charles Etheredge
Owner
5616279056

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