Provider Demographics
NPI:1013910371
Name:PIERCE, JAMES E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
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 1:939 BRYDEN AVE
Mailing Address - Street 2:#2
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-5057
Mailing Address - Country:US
Mailing Address - Phone:208-746-0204
Mailing Address - Fax:208-746-0237
Practice Address - Street 1:939 BRYDEN AVE
Practice Address - Street 2:#2
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-5057
Practice Address - Country:US
Practice Address - Phone:208-746-0204
Practice Address - Fax:208-746-0237
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD3909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist