Provider Demographics
NPI:1194789115
Name:PIERSON & WINDLE DDS, PA
Entity type:Organization
Organization Name:PIERSON & WINDLE DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:H
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-630-9339
Mailing Address - Street 1:9339 E. 21ST STREET N.
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2971
Mailing Address - Country:US
Mailing Address - Phone:316-630-9339
Mailing Address - Fax:316-630-9353
Practice Address - Street 1:9339 E. 21ST STREET N.
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2971
Practice Address - Country:US
Practice Address - Phone:316-630-9339
Practice Address - Fax:316-630-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5979122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty