Provider Demographics
NPI:1790966455
Name:PIERONI, GERALD J (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:J
Last Name:PIERONI
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 1:7760 N FRESNO ST STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2411
Mailing Address - Country:US
Mailing Address - Phone:559-432-1400
Mailing Address - Fax:559-432-6955
Practice Address - Street 1:7760 N FRESNO ST STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2411
Practice Address - Country:US
Practice Address - Phone:559-432-1400
Practice Address - Fax:559-432-6955
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251881223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics