Organization
TDC LANTANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN TOMALTY DMD (OWNER/DENTIST)
(561) 777-8980
Entity
Organization
Contact information
Practice address
6346 LANTANA RD SUITE 68, LAKE WORTH, FL 33463
(561) 439-5100
(561) 439-5100
Mailing address
6346 LANTANA RD STE 68, LAKE WORTH, FL 33463-6664
(561) 439-5100
(561) 439-5100
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2017
Last updated
07/21/2022
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