Provider Demographics
NPI:1104083161
Name:MAGLIANO, DONNA M (DDS)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:MAGLIANO
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 1:211 PHYSICIANS CT
Mailing Address - Street 2:SUITE D
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579
Mailing Address - Country:US
Mailing Address - Phone:854-854-9992
Mailing Address - Fax:
Practice Address - Street 1:211 PHYSICIANS CT
Practice Address - Street 2:SUITE D
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579
Practice Address - Country:US
Practice Address - Phone:854-854-9992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022613001223G0001X
SC97781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice