Provider Demographics
NPI:1881626539
Name:PIERCE, KATE M (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:M
Last Name:PIERCE
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-3807
Mailing Address - Country:US
Mailing Address - Phone:336-292-0411
Mailing Address - Fax:
Practice Address - Street 1:5408 W FRIENDLY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4367
Practice Address - Country:US
Practice Address - Phone:336-292-0411
Practice Address - Fax:336-292-9505
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC68601223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC902J0Medicaid
NCU89878Medicare UPIN