| NPI | 1053960419 |
|---|---|
| Doing Business As | BOCA RATON MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SEAN TOMALTY Owner 561-777-8980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2019-10-08 |