Provider Demographics
NPI:1194269803
Name:DIMINICK, JOSEPH (DMD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:DIMINICK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 SEMINARY DR
Mailing Address - Street 2:BUILDING E
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3734
Mailing Address - Country:US
Mailing Address - Phone:717-903-0345
Mailing Address - Fax:
Practice Address - Street 1:80 HUFF AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:717-903-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist