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General NPI Number Information
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NPI Number | 1801906482
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Entity Type | Organization
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Legal Business Name | BIERIE DENTAL PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 3455 STONEMAN ROAD SUITE 5
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City | DUBUQUE
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State | IA
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Zip | 52002-5292
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Country | US
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Telephone | 563-556-3213
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Fax | 563-556-5253
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Provider Business Mailing Address
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Address Line | 3455 STONEMAN ROAD SUITE 5
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City | DUBUQUE
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State | IA
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Zip | 52002-5292
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Country | US
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Telephone | 563-556-3213
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Fax | 563-556-5253
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Authorized Official
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Title or Position | PRES
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Name | DR. MICHAEL D BIERIE
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Credential | DDS
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Telephone | 563-556-3213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | IA05486
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License Number State | IA
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