Provider Demographics
NPI:1821569914
Name:PIERCE, MARIA BIANCA (RDH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:BIANCA
Last Name:PIERCE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:BIANCE
Other - Last Name:LONARDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH
Mailing Address - Street 1:238 OLD GRASSY HILL RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2426
Mailing Address - Country:US
Mailing Address - Phone:203-676-5095
Mailing Address - Fax:
Practice Address - Street 1:238 OLD GRASSY HILL RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-2426
Practice Address - Country:US
Practice Address - Phone:036-765-0952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8649124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008084714Medicaid