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General NPI Number Information
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NPI Number | 1851586440
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Entity Type | Individual
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Provider Name | LON MASSAGLIA DDS
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Gender | Male
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 578 NE DIXIE HWY
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City | JENSEN BEACH
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State | FL
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Zip | 34957-6115
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Country | US
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Telephone | 772-225-2111
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Fax | 772-225-2114
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Provider Business Mailing Address
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Address Line | 578 NE DIXIE HWY
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City | JENSEN BEACH
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State | FL
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Zip | 34957-6115
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Country | US
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Telephone | 772-225-2111
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Fax | 772-225-2114
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN9277
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License Number State | FL
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