Healthcare Provider Details

I. General information

NPI: 1366543126
Provider Name (Legal Business Name): LEONARD WAYNE PIERCE DDS MS PS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 N EMERSON STE 101
WENATCHEE WA
98801
US

IV. Provider business mailing address

620 N EMERSON STE 101
WENATCHEE WA
98801
US

V. Phone/Fax

Practice location:
  • Phone: 509-663-0068
  • Fax: 509-663-0060
Mailing address:
  • Phone: 509-663-0068
  • Fax: 509-663-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number6101
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: