Provider Demographics
NPI:1295973063
Name:PIERCE, PIERRE R (DDS)
Entity type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:R
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 1:7340 BEAUVOIR CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2510
Mailing Address - Country:US
Mailing Address - Phone:504-460-7765
Mailing Address - Fax:
Practice Address - Street 1:7101 HOFF ST BLDG 9240
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-5645
Practice Address - Country:US
Practice Address - Phone:706-544-3101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-31
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1847291Medicaid