Provider Demographics
NPI:1689783318
Name:PLUM, SUZANNE YOUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:YOUNG
Last Name:PLUM
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 1:11767 KATY FRWY SUITE 960
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TN
Mailing Address - Zip Code:77079
Mailing Address - Country:US
Mailing Address - Phone:281-558-1144
Mailing Address - Fax:281-558-0155
Practice Address - Street 1:11767 KATY FRWY SUITE 960
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TN
Practice Address - Zip Code:77079
Practice Address - Country:US
Practice Address - Phone:281-558-1144
Practice Address - Fax:281-558-0155
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17159122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist