Provider Demographics
NPI:1194820258
Name:PIERCE, BRIAN LEWIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:LEWIS
Last Name:PIERCE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 OLD HIGHWAY 8 NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-2793
Mailing Address - Country:US
Mailing Address - Phone:651-639-8445
Mailing Address - Fax:
Practice Address - Street 1:969 OLD HIGHWAY 8 NW
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-2793
Practice Address - Country:US
Practice Address - Phone:651-639-8445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist