MEDICARE: PLUMB DENTAL CARE, RAY E. PLUMB, D.D.S., P.A.

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	2974	AR

General Provider Information

NPI Number	:	1538137443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLUMB DENTAL CARE, RAY E. PLUMB, D.D.S., P.A.

Provider Business Mailing Address
First Line	:	3810 CAMP ROBINSON RD
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72118-4602
Country	:	US
Telephone Number	:	501-753-9158
Fax Number	:

Provider Business Practice Location Address
First Line	:	3810 CAMP ROBINSON RD
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72118-4602
Country	:	US
Telephone Number	:	501-753-9158
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RAY E. PLUMB
Credential	:	D.D.S.
Telephone Number	:	501-753-9158

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	08/22/2020

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