Provider Demographics
NPI:1639356355
Name:MATTHEW W PLUMMER JR DMD MPH DAPHNE L BROOKS REED DMD INC
Entity Type:Organization
Organization Name:MATTHEW W PLUMMER JR DMD MPH DAPHNE L BROOKS REED DMD INC
Other - Org Name:COSMETIC DENTISTRY OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:W
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD MPH
Authorized Official - Phone:713-757-1948
Mailing Address - Street 1:2101 CRAWFORD STREET
Mailing Address - Street 2:SUITE #204
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002
Mailing Address - Country:US
Mailing Address - Phone:713-757-1948
Mailing Address - Fax:713-757-9835
Practice Address - Street 1:2101 CRAWFORD STREET
Practice Address - Street 2:SUITE #204
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002
Practice Address - Country:US
Practice Address - Phone:713-757-1948
Practice Address - Fax:713-757-9835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10664TX1223G0001X
TX13442TX1223G0001X
TX21817TX1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty