Healthcare Provider Details

I. General information

NPI: 1992648802
Provider Name (Legal Business Name): THE BEST DENTIST IN SAINT AUGUSTINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 BLACKFORD WAY UNIT 197BC
SAINT AUGUSTINE FL
32086-1880
US

IV. Provider business mailing address

8794 W BOYNTON BEACH BLVD STE 218
BOYNTON BEACH FL
33472-4469
US

V. Phone/Fax

Practice location:
  • Phone: 561-789-6611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SEAN TOMALTY
Title or Position: TITLE MGR
Credential:
Phone: 561-789-6611