| My Dentist Of Port St. Lucie | |
|
1455 Sw Gatlin Blvd Port St. Lucie FL 34953 | |
| (561) 801-4233 | |
| Not Available |
| Full Name | My Dentist Of Port St. Lucie |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1455 Sw Gatlin Blvd, Port St. Lucie, Florida |
| Authorized Official Name and Position | Jordan Tomalty (OWNER) |
| Authorized Official Contact | 5616339676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Dentist Of Port St. Lucie 1455 Sw Gatlin Blvd Port St. Lucie FL 34953 Ph: (561) 801-4233 | My Dentist Of Port St. Lucie 1455 Sw Gatlin Blvd Port St. Lucie FL 34953 Ph: (561) 801-4233 |
| NPI Number | 1912783150 |
|---|---|
| Provider Enumeration Date | 09/05/2023 |
| Last Update Date | 09/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912783150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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