Provider Demographics
NPI:1750730917
Name:PYRON, KASEY MARIA (DMD)
Entity type:Individual
Prefix:DR
First Name:KASEY
Middle Name:MARIA
Last Name:PYRON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KASEY
Other - Middle Name:MARIA
Other - Last Name:KIRCHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:502 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DU QUOIN
Mailing Address - State:IL
Mailing Address - Zip Code:62832-1904
Mailing Address - Country:US
Mailing Address - Phone:618-542-3032
Mailing Address - Fax:618-542-3036
Practice Address - Street 1:502 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DU QUOIN
Practice Address - State:IL
Practice Address - Zip Code:62832-1904
Practice Address - Country:US
Practice Address - Phone:618-542-3032
Practice Address - Fax:618-542-3036
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.030658122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist