Provider Demographics
NPI:1174633325
Name:MASSEY, GEORGE B JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:B
Last Name:MASSEY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4951 BUSINESS PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-7174
Mailing Address - Country:US
Mailing Address - Phone:907-743-7366
Mailing Address - Fax:907-743-7241
Practice Address - Street 1:3909 ARCTIC BLVD STE 202
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5769
Practice Address - Country:US
Practice Address - Phone:907-339-2331
Practice Address - Fax:907-339-2332
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK10261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK3359359OtherUNITED CONCORDIA
AKDD10261Medicaid
261896261896OtherBLUE CROSS BLUE SHIELD