Provider Demographics
NPI:1316909401
Name:KIER, W. CALVIN (DMD)
Entity type:Individual
Prefix:
First Name:W. CALVIN
Middle Name:
Last Name:KIER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 GREAT POND DR
Mailing Address - Street 2:SUITE 2003
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7244
Mailing Address - Country:US
Mailing Address - Phone:407-772-5124
Mailing Address - Fax:407-788-3572
Practice Address - Street 1:801 N GREENGATE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6394
Practice Address - Country:US
Practice Address - Phone:724-853-2355
Practice Address - Fax:724-853-0935
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0167341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005533420001Medicaid
PA0005533420011Medicaid
PA0005533420007Medicaid
PA0005533420003Medicaid
PA0005533420015Medicaid
PA0005533420002Medicaid
PA0005533420018Medicaid
PA0005533420019Medicaid
PA0005533420020Medicaid
PA0005533420017Medicaid
PA0005533420005Medicaid
PA0005533420008Medicaid
PA0005533420009Medicaid