MEDICARE: BIERIE DENTAL 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
1	261QD0000X	Dental Clinic/Center	IA05486	IA

Other Identifiers

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

General Provider Information

NPI Number	:	1801906482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIERIE DENTAL PC

Provider Business Mailing Address
First Line	:	3455 STONEMAN ROAD
Second Line	:	SUITE 5
City	:	DUBUQUE
State	:	IA
Zip	:	52002-5292
Country	:	US
Telephone Number	:	563-556-3213
Fax Number	:	563-556-5253

Provider Business Practice Location Address
First Line	:	3455 STONEMAN ROAD
Second Line	:	SUITE 5
City	:	DUBUQUE
State	:	IA
Zip	:	52002-5292
Country	:	US
Telephone Number	:	563-556-3213
Fax Number	:	563-556-5253

Authorized Official
Title or Position	:	PRES
Name	:	DR. MICHAEL D BIERIE
Credential	:	DDS
Telephone Number	:	563-556-3213

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	09/08/2015

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Directions to “BIERIE DENTAL PC ” Practice Location

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