| Organization Name: | DRS ETHEREDGE & SCHRY DENTAL |
| NPI Number: | 1033446026 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES ETHEREDGE (OWNER) |
| Mailing Address: | 3365 Burns Rd Suite 212 Palm Beach Gardens |
| State: | FL US |
| Postal Code: | 334104326 |
| Phone Number: | 5616279056 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2009 |
| NPI Last Update Date: | 12/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |