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NPI Code Detail

MEDICARE: ROBERT E PIERCE, DMD, PC

MEDICARE: ROBERT E PIERCE, DMD, PC
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
1122300000XDentist
21223G0001XGeneral Practice Dentistry

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205157294
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT E PIERCE, DMD, PC
Provider Business Mailing Address
First Line : 1450 OLD CHEMSTRAND RD #448
Second Line :
City : GONZALEZ
State : FL
Zip : 32560-7806
Country : US
Telephone Number : 850-502-6488
Fax Number : 850-462-2430
Provider Business Practice Location Address
First Line : DOCTOR'S MEMORIAL HOSPITAL
Second Line : 2600 HOSPITAL DR DEPT OF SURGERY
City : BONIFAY
State : FL
Zip : 32425-4264
Country : US
Telephone Number : 850-502-0011
Fax Number : 251-217-9070
Authorized Official
Title or Position : PRES/OWNER
Name : MR. ROBERT EDWARD PIERCE
Credential : DMD
Telephone Number : 850-502-0011
Provider Enumeration Date : 06/14/2010
Last Update Date : 01/19/2024

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