Provider Demographics
NPI:1710106273
Name:MCCARTHY, EDWIN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:G
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N FEDERAL HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1034
Mailing Address - Country:US
Mailing Address - Phone:954-946-7980
Mailing Address - Fax:954-946-2206
Practice Address - Street 1:1800 NORTH FEDERAL HIGHWAY
Practice Address - Street 2:SUITE 103
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1034
Practice Address - Country:US
Practice Address - Phone:954-946-7980
Practice Address - Fax:954-946-2206
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL048791223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics