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General NPI Number Information
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NPI Number | 1407941065
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Entity Type | Individual
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Provider Name | MARK A PIGNO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/13/2009
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Provider Practice Location Address
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Address Line | 3510 FANNIN STREET
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City | BEAUMONT
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State | TX
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Zip | 77701
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Country | US
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Telephone | 409-835-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 4223 HILLBROOK DRIVE
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City | ORANGE
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State | TX
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Zip | 77632
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Country | US
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Telephone | 409-835-5300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 18252
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 4443
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 18252
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License Number State | TX
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