Provider Demographics
NPI:1609865849
Name:CINNER, PETER G (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:G
Last Name:CINNER
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 1:138 RUSSELL ST
Mailing Address - Street 2:P.O. BOX 408
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9533
Mailing Address - Country:US
Mailing Address - Phone:413-584-6275
Mailing Address - Fax:413-584-5938
Practice Address - Street 1:138 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9533
Practice Address - Country:US
Practice Address - Phone:413-584-6275
Practice Address - Fax:413-584-5938
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11754122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX08422OtherBLUE CROSS BLUE SHIELD PR
MA835867OtherUNITED CONCORDIA PROVIDER