Healthcare Provider Details

I. General information

NPI: 1043663347
Provider Name (Legal Business Name): ASHLEY HEINECKE MASSEY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7135 MARINER BLVD
SPRING HILL FL
34609-1048
US

IV. Provider business mailing address

3709 BEAUMONT LOOP
SPRING HILL FL
34609-0601
US

V. Phone/Fax

Practice location:
  • Phone: 352-584-5303
  • Fax:
Mailing address:
  • Phone: 352-584-5303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN22000
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: