Basic Information
| Provider Information | |||||||||
| NPI: | 1962635375 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PLESSMAN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 OCEAN VIEW AVE | ||||||||
| Address2: | |||||||||
| City: | MYSTIC | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063552216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605361055 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 888 WORCESTER ST | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | WELLESLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024823744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6179646681 | ||||||||
| FaxNumber: | 8886620859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2009 | ||||||||
| LastUpdateDate: | 06/13/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DEN03055 | RI | Y | Dental Providers | Dentist | 122300000X | 008612 | CT | N | Dental Providers | Dentist |
No ID Information.