MEDICARE: DR. DIANE T. MCGINTY DMD, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	DN13448	FL

General Provider Information

NPI Number	:	1831306737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE T. MCGINTY DMD, MS

Provider Business Mailing Address
First Line	:	3020 NE 32 AVE
Second Line	:	STE 322
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-990-5363
Fax Number	:	954-990-5377

Provider Business Practice Location Address
First Line	:	3020 NE 32 AVE
Second Line	:	STE 322
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-990-5363
Fax Number	:	954-990-5377

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	01/23/2018

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