Provider Demographics
NPI:1801983721
Name:PIRMANN, PETER JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAMES
Last Name:PIRMANN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 ROBINSON CIR
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-1048
Mailing Address - Country:US
Mailing Address - Phone:618-529-2212
Mailing Address - Fax:618-351-1219
Practice Address - Street 1:420 ROBINSON CIR
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-1048
Practice Address - Country:US
Practice Address - Phone:618-529-2212
Practice Address - Fax:618-351-1219
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice