Provider Demographics
NPI:1235274325
Name:PLAISTED, VIRGINIA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:A
Last Name:PLAISTED
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 CENTRE POINTE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1112
Mailing Address - Country:US
Mailing Address - Phone:518-439-3299
Mailing Address - Fax:518-439-3589
Practice Address - Street 1:74 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1537
Practice Address - Country:US
Practice Address - Phone:518-439-3299
Practice Address - Fax:518-439-3589
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0360461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice