Provider Demographics
NPI:1477637056
Name:THOMAS F. PLUNKET D.M.D., P.A.
Entity Type:Organization
Organization Name:THOMAS F. PLUNKET D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:PLUNKETT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:863-646-0313
Mailing Address - Street 1:200 LAKE HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2632
Mailing Address - Country:US
Mailing Address - Phone:863-646-0313
Mailing Address - Fax:863-647-9187
Practice Address - Street 1:200 LAKE HARRIS DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2632
Practice Address - Country:US
Practice Address - Phone:863-646-0313
Practice Address - Fax:863-647-9187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN123851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty