Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2007011940 | MO |
NPI | 1083817142 |
---|---|
Provider Name | Dr. Makepeace B Charles |
First Address | Palm Beach Gardens, FL 33410-3335 |
Second Address | Palm Beach Gardens, FL 33410-3335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 23/07/2013 |