Provider Demographics
NPI:1093979098
Name:DONNA D. MASSEY D.D.S.
Entity Type:Organization
Organization Name:DONNA D. MASSEY D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-535-4050
Mailing Address - Street 1:7215 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602-3214
Mailing Address - Country:US
Mailing Address - Phone:870-535-4050
Mailing Address - Fax:870-535-2819
Practice Address - Street 1:7215 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-3214
Practice Address - Country:US
Practice Address - Phone:870-535-4050
Practice Address - Fax:870-535-2819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR2649261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental