Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DI14536 | NJ |
NPI | 1154312296 |
---|---|
Provider Name | Dr. Michael Plotno |
First Address | Livingston, NJ 07039-4896 |
Second Address | Livingston, NJ 07039-4896 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 08/07/2007 |