Provider Demographics
NPI:1376690677
Name:MASSEY, DEAN BENNETT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:BENNETT
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 1:9 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-1322
Mailing Address - Country:US
Mailing Address - Phone:410-968-1273
Mailing Address - Fax:410-968-1276
Practice Address - Street 1:1820 SWEETBAY DR
Practice Address - Street 2:SUITE 104
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1428
Practice Address - Country:US
Practice Address - Phone:410-543-2223
Practice Address - Fax:410-543-8529
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD69591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice