| NPI | 1285468629 |
|---|---|
| Doing Business As | MY DENTIST OF WEST LAKE WORTH |
| Entity Type | Organization |
| Authorized Contact | JORDAN TOMALTY CEO 561-633-9676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2024-08-28 |