Organization
ITD ASSOCIATES, P.A.
Active
Other names
Indrio Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS MICHAEL HICKEY DMD (PRESIDENT)
(772) 359-8962
Entity
Organization
Contact information
Practice address
4832 N. KINGS HIGHWAY, FORT PIERCE, FL 34951
(772) 468-6226
(772) 468-6226
Mailing address
499 NW PRIMA VISTA BLVD., PORT SAINT LUCIE, FL 34983
(772) 335-7392
(888) 610-3835
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/28/2010
Last updated
04/19/2018
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