Provider Demographics
NPI:1871682625
Name:GRIFFITH, DIANA EILEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:EILEEN
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6360 PINE RIDGE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3907
Mailing Address - Country:US
Mailing Address - Phone:239-354-5353
Mailing Address - Fax:239-354-5354
Practice Address - Street 1:6360 PINE RIDGE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3907
Practice Address - Country:US
Practice Address - Phone:239-354-5353
Practice Address - Fax:239-354-5354
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 151651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice