Individual
DR. MICHAEL J. MAGINNIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
7742 OFFICE PARK BLVD, BLDG A, SUITE 1, BATON ROUGE, LA 70809-7601
(225) 201-1000
(225) 201-1005
Mailing address
7742 OFFICE PARK BLVD, BLDG A, SUITE 1, BATON ROUGE, LA 70809-7601
(225) 201-1000
(225) 201-1005
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
LA2460
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1824607
—
LA
01
—
18931
STATE DRUG LICENSE #
LA
01
—
F7198
BC/BS PROVIDER #
LA
01
—
LA2460
DENTAL LICENSE #
LA
Enumeration date
05/27/2005
Last updated
03/07/2023
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