Provider Demographics
NPI:1548377765
Name:PIERCE, KURT (DDS MS)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:PIERCE
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 SOLAREX CT #209
Mailing Address - Street 2:
Mailing Address - City:FREDERICH
Mailing Address - State:MD
Mailing Address - Zip Code:21708
Mailing Address - Country:US
Mailing Address - Phone:301-694-7100
Mailing Address - Fax:
Practice Address - Street 1:604 SOLAREX CT #209
Practice Address - Street 2:
Practice Address - City:FREDERICH
Practice Address - State:MD
Practice Address - Zip Code:21708
Practice Address - Country:US
Practice Address - Phone:301-694-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD98701223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics