Provider Demographics
NPI:1164696605
Name:MICHAEL PLOTNO, D.M.D. - SHARI LYNNE SUMMERS, D.M.D., P.A.
Entity Type:Organization
Organization Name:MICHAEL PLOTNO, D.M.D. - SHARI LYNNE SUMMERS, D.M.D., P.A.
Other - Org Name:LIVINGSTON PEDIATRIC DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOTNO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-994-6600
Mailing Address - Street 1:315 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4896
Mailing Address - Country:US
Mailing Address - Phone:973-994-6600
Mailing Address - Fax:973-994-0353
Practice Address - Street 1:315 E NORTHFIELD RD
Practice Address - Street 2:SUITE 2D
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4896
Practice Address - Country:US
Practice Address - Phone:973-994-6600
Practice Address - Fax:973-994-0353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI14563261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental