Provider Demographics
NPI:1538362926
Name:PIERCE, MICHAEL JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
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 1:4330 44TH ST SW
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-2349
Mailing Address - Country:US
Mailing Address - Phone:616-534-1415
Mailing Address - Fax:616-534-0586
Practice Address - Street 1:4330 44TH ST SW
Practice Address - Street 2:SUITE 105
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2349
Practice Address - Country:US
Practice Address - Phone:616-534-1415
Practice Address - Fax:616-534-0586
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1283209122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist