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General NPI Number Information
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NPI Number | 1427117076
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Entity Type | Individual
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Provider Name | BRUCE A MASSING DDS
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 95A CLUBHOUSE LANE CLUBHOUSE
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City | LEBANON
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State | OH
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Zip | 45036-9897
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Country | US
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Telephone | 513-320-6851
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Fax |
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Provider Business Mailing Address
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Address Line | 95 CLUBHOUSE LN UNIT A
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City | LEBANON
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State | OH
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Zip | 45036-9879
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Country | US
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Telephone | 513-320-6851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30020737
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License Number State | OH
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