Provider Demographics
NPI:1619987989
Name:PLUMMER, RICHARD W (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:PLUMMER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 ROYAL PALM SQUARE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-1074
Mailing Address - Country:US
Mailing Address - Phone:239-939-2433
Mailing Address - Fax:239-939-5510
Practice Address - Street 1:1400 ROYAL PALM SQUARE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-1074
Practice Address - Country:US
Practice Address - Phone:239-939-2433
Practice Address - Fax:239-939-5510
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7576122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist