Provider Demographics
NPI:1447381017
Name:PLOTNICK, SUSAN S (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:S
Last Name:PLOTNICK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1672 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1078
Mailing Address - Country:US
Mailing Address - Phone:215-343-0900
Mailing Address - Fax:215-491-0916
Practice Address - Street 1:1672 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1078
Practice Address - Country:US
Practice Address - Phone:215-343-0900
Practice Address - Fax:215-491-0916
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024705L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice