Provider Demographics
NPI:1831306737
Name:MCGINTY, DIANE T (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:T
Last Name:MCGINTY
Suffix:
Gender:F
Credentials:DMD, MS
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Mailing Address - Street 1:3020 NE 32 AVE
Mailing Address - Street 2:STE 322
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-990-5363
Mailing Address - Fax:954-990-5377
Practice Address - Street 1:3020 NE 32 AVE
Practice Address - Street 2:STE 322
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-990-5363
Practice Address - Fax:954-990-5377
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN134481223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics