Provider Demographics
NPI:1578637872
Name:PLOEGER, AMY MEYER (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:MEYER
Last Name:PLOEGER
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 1:2891 E 450 S
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-9727
Mailing Address - Country:US
Mailing Address - Phone:765-938-1204
Mailing Address - Fax:
Practice Address - Street 1:8788 S STATE ROAD 109
Practice Address - Street 2:BOX 119
Practice Address - City:KNIGHTSTOWN
Practice Address - State:IN
Practice Address - Zip Code:46148-9592
Practice Address - Country:US
Practice Address - Phone:765-345-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120099791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice