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NPI Code Detail

MEDICARE: DR. NANCY B MASSEY D.D.S.

MEDICARE: DR. NANCY B MASSEY D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry4789TN

General Provider Information

NPI Number : 1851420228
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANCY B MASSEY D.D.S.
Provider Business Mailing Address
First Line : 4662 ROBINSON LOOP E
Second Line :
City : OLIVE BRANCH
State : MS
Zip : 38654-8176
Country : US
Telephone Number : 901-496-9641
Fax Number :
Provider Business Practice Location Address
First Line : 845 S HIGHLAND ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4254
Country : US
Telephone Number : 901-323-8488
Fax Number : 901-323-9489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2007
Last Update Date : 10/22/2012

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