Provider Demographics
NPI:1164482964
Name:PIERCE, GRAHAM M (DDS)
Entity type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:M
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 1:289 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-1511
Mailing Address - Country:US
Mailing Address - Phone:231-526-9611
Mailing Address - Fax:231-526-2051
Practice Address - Street 1:289 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-1511
Practice Address - Country:US
Practice Address - Phone:231-526-9611
Practice Address - Fax:231-526-2051
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010082771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice