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NPI Code Detail

MEDICARE: DR. MEGAN DIMINICK D.M.D.

MEDICARE: DR. MEGAN DIMINICK D.M.D.
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
11223G0001XGeneral Practice Dentistry040913PA

General Provider Information

NPI Number : 1972057859
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEGAN DIMINICK D.M.D.
Provider Business Mailing Address
First Line : PO BOX 860036
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55486-0036
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4004 TRINDLE RD
Second Line :
City : CAMP HILL
State : PA
Zip : 17011-4242
Country : US
Telephone Number : 717-737-5120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2016
Last Update Date : 02/08/2022

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