MEDICARE: MICHAEL H PIERCE DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	3532	SC

General Provider Information

NPI Number	:	1073636999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL H PIERCE DDS PA

Provider Business Mailing Address
First Line	:	1063 CHUCK DAWLEY BLVD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-4181
Country	:	US
Telephone Number	:	843-884-3236
Fax Number	:

Provider Business Practice Location Address
First Line	:	1063 CHUCK DAWLEY BLVD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-4181
Country	:	US
Telephone Number	:	843-884-3236
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY M PIERCE
Credential	:	DMD, MS
Telephone Number	:	843-884-3236

Provider Enumeration Date	:	04/07/2007
Last Update Date	:	08/22/2020

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