Provider Demographics
NPI:1619984788
Name:PLOTKA, RONALD T
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:T
Last Name:PLOTKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 HUMPHREY ST
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2548
Mailing Address - Country:US
Mailing Address - Phone:781-599-8300
Mailing Address - Fax:
Practice Address - Street 1:293 HUMPHREY ST
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-2548
Practice Address - Country:US
Practice Address - Phone:781-599-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11381122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist