Provider Demographics
NPI:1275920761
Name:D MATTHEW PIERCE DDS LLC
Entity Type:Organization
Organization Name:D MATTHEW PIERCE DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-217-9632
Mailing Address - Street 1:324 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2199
Mailing Address - Country:US
Mailing Address - Phone:812-522-8608
Mailing Address - Fax:812-523-6202
Practice Address - Street 1:324 W 2ND ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2199
Practice Address - Country:US
Practice Address - Phone:812-522-8608
Practice Address - Fax:812-523-6202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12011941A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty