Provider Demographics
NPI:1336291632
Name:DOAN, PETER P (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:P
Last Name:DOAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 S HIGHWAY 160
Mailing Address - Street 2:SUITE 403
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-4698
Mailing Address - Country:US
Mailing Address - Phone:775-537-0911
Mailing Address - Fax:775-537-0922
Practice Address - Street 1:921 S HIGHWAY 160
Practice Address - Street 2:SUITE 403
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-4698
Practice Address - Country:US
Practice Address - Phone:775-537-0911
Practice Address - Fax:775-537-0922
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV46931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice