MEDICARE: DR. JACOB M. PLAWNER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	13613	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144212234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB M. PLAWNER DDS

Provider Business Mailing Address
First Line	:	51 HAMILTON DR E
Second Line	:
City	:	NORTH CALDWELL
State	:	NJ
Zip	:	07006-4627
Country	:	US
Telephone Number	:	973-420-1474
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 N BROAD ST
Second Line	:	SUITE 101
City	:	ELIZABETH
State	:	NJ
Zip	:	07208-2310
Country	:	US
Telephone Number	:	908-354-8678
Fax Number	:	908-354-5864

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	07/08/2007

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