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General NPI Number Information
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NPI Number | 1275920761
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Entity Type | Organization
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Legal Business Name | D MATTHEW PIERCE DDS LLC
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 324 W 2ND ST
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City | SEYMOUR
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State | IN
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Zip | 47274-2199
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Country | US
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Telephone | 812-522-8608
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Fax | 812-523-6202
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Provider Business Mailing Address
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Address Line | 324 W 2ND ST
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City | SEYMOUR
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State | IN
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Zip | 47274-2199
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Country | US
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Telephone | 812-522-8608
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Fax | 812-523-6202
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Authorized Official
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Title or Position | OWNER/GENERAL DENTIST
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Name | DR. DENNIS MATTHEW PIERCE
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Credential | D.D.S.
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Telephone | 317-217-9632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12011941A
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License Number State |
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