Provider Demographics
NPI:1255072690
Name:SMITH, PIERCE JEFFREY (DDS)
Entity type:Individual
Prefix:DR
First Name:PIERCE
Middle Name:JEFFREY
Last Name:SMITH
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:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:SD
Mailing Address - Zip Code:57311-0441
Mailing Address - Country:US
Mailing Address - Phone:605-999-1796
Mailing Address - Fax:
Practice Address - Street 1:916 S ROWLEY ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-4441
Practice Address - Country:US
Practice Address - Phone:605-996-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program