Healthcare Provider Details

I. General information

NPI: 1720393929
Provider Name (Legal Business Name): MARGARET MACMINN D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 07/28/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2186 GEARY BLVD STE 103
SAN FRANCISCO CA
94115-3456
US

IV. Provider business mailing address

2186 GEARY BLVD STE 103
SAN FRANCISCO CA
94115-3456
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number59463
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: