Healthcare Provider Details

I. General information

NPI: 1457452625
Provider Name (Legal Business Name): TODD R. PLOCHER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25982 PALA SUITE 200
MISSION VIEJO CA
92691-6719
US

IV. Provider business mailing address

25982 PALA DRIVE SUITE 200
MISSION VIEJO CA
92691
US

V. Phone/Fax

Practice location:
  • Phone: 949-472-5499
  • Fax: 949-472-0948
Mailing address:
  • Phone: 949-472-5499
  • Fax: 949-472-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number41774
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: