Provider Demographics
NPI:1114050424
Name:MASSIE, TERRY E (DMD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:E
Last Name:MASSIE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 E GRANT ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-2279
Mailing Address - Country:US
Mailing Address - Phone:724-654-3221
Mailing Address - Fax:724-654-3265
Practice Address - Street 1:22 E GRANT ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-2279
Practice Address - Country:US
Practice Address - Phone:724-654-3221
Practice Address - Fax:724-654-3265
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018727L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice