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Organization
EDGEWATER FAMILY DENTISTRY PLLC
Active
Organization
EDGEWATER FAMILY DENTISTRY PLLC
Active
Other names
Edgewater Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN TOMALTY DMD (OWNER)
(561) 633-9676
Entity
Organization
Contact information
Practice address
3512 DEL PRADO BLVD S STE 102, CAPE CORAL, FL 33904-7261
(239) 540-1033
Mailing address
3512 DEL PRADO BLVD S STE 102, CAPE CORAL, FL 33904-7261
(239) 540-1033
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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