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General NPI Number Information
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NPI Number | 1942769898
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Entity Type | Organization
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Legal Business Name | PIERCE AESTHETICS DENTAL GROUP OF ORANGE COUNTY
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 2492 WALNUT AVE STE 250
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City | TUSTIN
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State | CA
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Zip | 92780-6963
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Country | US
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Telephone | 949-350-0654
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Fax |
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Provider Business Mailing Address
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Address Line | 2492 WALNUT AVE STE 250
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City | TUSTIN
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State | CA
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Zip | 92780-6963
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Country | US
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Telephone | 949-379-6607
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Fax |
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Authorized Official
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Title or Position | OWNER DR
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Name | DR. SEAN PIERCE
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Credential | DDS
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Telephone | 949-379-6607
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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