MEDICARE: BRITNY MASSEY DDS,PC

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
1	1223G0001X	General Practice Dentistry	9637	CO

General Provider Information

NPI Number	:	1639310873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRITNY MASSEY DDS,PC

Provider Business Mailing Address
First Line	:	6514 S ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8614
Country	:	US
Telephone Number	:	719-442-1960
Fax Number	:	719-527-0190

Provider Business Practice Location Address
First Line	:	6514 S ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8614
Country	:	US
Telephone Number	:	719-442-1960
Fax Number	:	719-527-0190

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	BRITNY MASSEY
Credential	:	DDS
Telephone Number	:	719-442-1960

Provider Enumeration Date	:	03/18/2009
Last Update Date	:	03/18/2009

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