Provider Demographics
NPI:1093922940
Name:WILLIAM L PEARCE JR.,DDS,PC
Entity Type:Organization
Organization Name:WILLIAM L PEARCE JR.,DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:515-288-5511
Mailing Address - Street 1:974 73RD ST
Mailing Address - Street 2:SUITE37
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50312-1024
Mailing Address - Country:US
Mailing Address - Phone:515-288-5511
Mailing Address - Fax:
Practice Address - Street 1:974 73RD ST
Practice Address - Street 2:SUITE37
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50312-1024
Practice Address - Country:US
Practice Address - Phone:515-288-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA57891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1119750Medicaid