Provider Demographics
NPI:1477536001
Name:PIERCE, JOHN MORRIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MORRIS
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 1:580 S AIKEN AVE
Mailing Address - Street 2:SUITE 630
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1531
Mailing Address - Country:US
Mailing Address - Phone:412-687-5589
Mailing Address - Fax:412-687-2078
Practice Address - Street 1:580 S AIKEN AVE
Practice Address - Street 2:SUITE 630
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1531
Practice Address - Country:US
Practice Address - Phone:412-687-5589
Practice Address - Fax:412-687-2078
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015938L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA061781Medicare ID - Type UnspecifiedMEDICARE NUMBER
PAT27911Medicare UPIN