Provider Demographics
NPI:1962783266
Name:MCGURK, JONI L (RDH)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:L
Last Name:MCGURK
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11160 8TH ST E
Mailing Address - Street 2:
Mailing Address - City:TREASURE ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33706-1104
Mailing Address - Country:US
Mailing Address - Phone:727-422-5640
Mailing Address - Fax:
Practice Address - Street 1:11160 8TH ST E
Practice Address - Street 2:
Practice Address - City:TREASURE ISLAND
Practice Address - State:FL
Practice Address - Zip Code:33706-1104
Practice Address - Country:US
Practice Address - Phone:727-422-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH6889124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist