Provider Demographics
NPI:1184824740
Name:MASSEY, JOSHUA BENJAMIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:BENJAMIN
Last Name:MASSEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 WATERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-8005
Mailing Address - Country:US
Mailing Address - Phone:304-617-0342
Mailing Address - Fax:
Practice Address - Street 1:415 ROBERTSON BLVD STE A
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-5713
Practice Address - Country:US
Practice Address - Phone:843-549-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4378122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist