Tdc Port St. Lucie LLC
NPI #1003471459 in Port St Lucie, Florida
Provider Information
- NPI Number
- 1003471459
- Entity Type
- Organization
- Organization Name
- Tdc Port St. Lucie LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 1, 2019
- Last Updated
- May 1, 2019
Practice Location
- Address
- 1161 SE PORT ST LUCIE BLVD
- City
- Port St Lucie
- State
- Florida
- ZIP Code
- 34952-5332
- Phone
- (772) 335-7766
Authorized Official
- Name
- DR. SEAN TOMALTY, DMD
- Title
- CEO
- Phone
- (561) 789-6611
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Endodontics — Endodontics |
| Dentist - Periodontics — Periodontics |
| Dentist - General Practice — General Practice |
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