Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN 20627 | FL |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 20627 | FL |
NPI | 1063899102 |
---|---|
Provider Name | Dr. Robert Donald Pierre II |
First Address | Lake Mary, FL 32746-6317 |
Second Address | Sanford, FL 32771-7497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2015 |
Last Update Date | 08/07/2020 |