Provider Demographics
NPI:1285413443
Name:PEARCE DENTAL MANAGEMENT
Entity type:Organization
Organization Name:PEARCE DENTAL MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-287-3660
Mailing Address - Street 1:3005 DIXIE HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2300
Mailing Address - Country:US
Mailing Address - Phone:859-287-3660
Mailing Address - Fax:859-287-3661
Practice Address - Street 1:3005 DIXIE HWY STE 100
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-2300
Practice Address - Country:US
Practice Address - Phone:859-287-3660
Practice Address - Fax:859-287-3661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental