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General NPI Number Information
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NPI Number | 1851428296
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Entity Type | Individual
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Provider Name | ROBERT EDWARD PIERCE DMD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 2600 HOSPITAL DR
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City | BONIFAY
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State | FL
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Zip | 32425-4264
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Country | US
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Telephone | 850-502-6488
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Fax | 850-462-2430
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Provider Business Mailing Address
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Address Line | 1450 OLD CHEMSTRAND RD UNIT 448
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City | GONZALEZ
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State | FL
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Zip | 32560-7818
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Country | US
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Telephone | 850-502-6488
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Fax | 850-462-2430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | AL3619
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN17449
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License Number State | FL
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