MEDICARE: DR. GILLIAN N PLUMMER-MOLINA DMD

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	DN19982	FL

General Provider Information

NPI Number	:	1285987750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GILLIAN N PLUMMER-MOLINA DMD

Provider Business Mailing Address
First Line	:	7211 VANDERBILT BEACH RD
Second Line	:	SUITE #12
City	:	NAPLES
State	:	FL
Zip	:	34119
Country	:	US
Telephone Number	:	239-271-2497
Fax Number	:	239-603-6403

Provider Business Practice Location Address
First Line	:	7211 VANDERBILT BEACH RD,
Second Line	:	SUITE #12
City	:	NAPLES
State	:	FL
Zip	:	34119-3411
Country	:	US
Telephone Number	:	239-271-2497
Fax Number	:

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

Provider Enumeration Date	:	10/22/2012
Last Update Date	:	03/11/2019

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