MEDICARE: SHAUNA LEE PIER DDS

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	1223G0001X	General Practice Dentistry	D7081	OR

General Provider Information

NPI Number	:	1932160553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUNA LEE PIER DDS

Provider Business Mailing Address
First Line	:	PO BOX 770
Second Line	:
City	:	MOUNT ANGEL
State	:	OR
Zip	:	97362-0770
Country	:	US
Telephone Number	:	503-845-6891
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 CHARLES ST
Second Line	:
City	:	MOUNT ANGEL
State	:	OR
Zip	:	97362-9635
Country	:	US
Telephone Number	:	503-845-6891
Fax Number	:	503-845-2616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	07/08/2007

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