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General NPI Number Information
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NPI Number | 1417158809
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Entity Type | Organization
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Legal Business Name | JACQUELINE M. PLEMONS, DDS, MS
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 6031 SHERRY LN
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City | DALLAS
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State | TX
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Zip | 75225-6402
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Country | US
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Telephone | 214-369-8585
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Fax | 214-696-9477
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Provider Business Mailing Address
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Address Line | 6031 SHERRY LN
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City | DALLAS
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State | TX
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Zip | 75225-6402
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Country | US
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Telephone | 214-369-8585
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Fax | 214-696-9477
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE PLEMONS
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Credential | DDS, MS
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Telephone | 214-369-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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