Healthcare Provider Details

I. General information

NPI: 1265569750
Provider Name (Legal Business Name): JEFFREY MICHAEL PLYLER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 DORIS CT
HOT SPRINGS AR
71913-4044
US

IV. Provider business mailing address

4039 CENTRAL AVENUE
HOT SPRINGS AR
71913
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-7113
  • Fax: 501-623-7523
Mailing address:
  • Phone: 501-623-7113
  • Fax: 833-815-0575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3217
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: