MEDICARE: PINNACLE ORTHODONTICS - JAMIE M SIGNORINO DDS, MSD - PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1174115547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE ORTHODONTICS - JAMIE M SIGNORINO DDS, MSD - PLLC

Provider Business Mailing Address
First Line	:	4003 W FINANCIAL PKWY
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-1449
Country	:	US
Telephone Number	:	479-877-6565
Fax Number	:	479-877-6569

Provider Business Practice Location Address
First Line	:	4003 W FINANCIAL PKWY
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-1449
Country	:	US
Telephone Number	:	479-877-6565
Fax Number	:	479-877-6569

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	MRS. JAMIE M SIGNORINO
Credential	:	DDS, MSD
Telephone Number	:	479-877-6565

Provider Enumeration Date	:	02/08/2021
Last Update Date	:	02/08/2021

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