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General NPI Number Information
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NPI Number | 1477637056
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Entity Type | Organization
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Legal Business Name | THOMAS F. PLUNKET D.M.D., P.A.
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 LAKE HARRIS DR
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City | LAKELAND
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State | FL
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Zip | 33813-2632
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Country | US
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Telephone | 863-646-0313
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Fax | 863-647-9187
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Provider Business Mailing Address
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Address Line | 200 LAKE HARRIS DR
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City | LAKELAND
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State | FL
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Zip | 33813-2632
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Country | US
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Telephone | 863-646-0313
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Fax | 863-647-9187
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS F PLUNKETT
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Credential | D.M.D.
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Telephone | 863-646-0313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN12385
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License Number State | FL
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