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General NPI Number Information
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NPI Number | 1982883039
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Entity Type | Organization
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Legal Business Name | KEVIN S. PIERCE, D.D.S. P.A.
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 1724 EXECUTIVE SQ
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City | JONESBORO
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State | AR
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Zip | 72401-6092
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Country | US
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Telephone | 870-268-8600
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Fax | 870-268-0044
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Provider Business Mailing Address
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Address Line | 1724 EXECUTIVE SQ
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City | JONESBORO
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State | AR
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Zip | 72401-6092
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Country | US
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Telephone | 870-268-8600
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Fax | 870-268-0044
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KEVIN S PIERCE
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Credential | D.D.S.
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Telephone | 870-268-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 3398
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License Number State | AR
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