Provider Demographics
NPI:1306001458
Name:PIGNATARO DENTAL, P.C.
Entity Type:Organization
Organization Name:PIGNATARO DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:PIGNATARO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:256-880-1165
Mailing Address - Street 1:4038 BALMORAL DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6421
Mailing Address - Country:US
Mailing Address - Phone:256-880-1165
Mailing Address - Fax:256-880-4041
Practice Address - Street 1:4038 BALMORAL DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6421
Practice Address - Country:US
Practice Address - Phone:256-880-1165
Practice Address - Fax:256-880-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000095395Medicaid