Provider Demographics
NPI:1376264861
Name:PLUEGER, HEATHER PATRICIA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:PATRICIA
Last Name:PLUEGER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:TEA
Mailing Address - State:SD
Mailing Address - Zip Code:57064-2388
Mailing Address - Country:US
Mailing Address - Phone:605-421-8552
Mailing Address - Fax:
Practice Address - Street 1:5121 S SOLBERG AVE STE 120
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2246
Practice Address - Country:US
Practice Address - Phone:605-339-2955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDDH1734124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist