Provider Demographics
NPI:1245625342
Name:MAGURNO, MARIA A (DDS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:MAGURNO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:A
Other - Last Name:MAGURNO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PROSTHODONTIST
Mailing Address - Street 1:1436 MEADOWS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1805
Mailing Address - Country:US
Mailing Address - Phone:954-235-2443
Mailing Address - Fax:
Practice Address - Street 1:4849 SW 148TH AVE
Practice Address - Street 2:REGENCY SQUARE,
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331
Practice Address - Country:US
Practice Address - Phone:954-434-1702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20559122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics