Provider Demographics
NPI:1477608305
Name:LINDA J MASSOD DMDPC
Entity Type:Organization
Organization Name:LINDA J MASSOD DMDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MASSOD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-774-4505
Mailing Address - Street 1:85 CONSTITUTION LANE
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923
Mailing Address - Country:US
Mailing Address - Phone:978-774-4505
Mailing Address - Fax:978-762-7470
Practice Address - Street 1:85 CONSTITUTION LANE
Practice Address - Street 2:SUITE 2G
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923
Practice Address - Country:US
Practice Address - Phone:978-774-4505
Practice Address - Fax:978-762-7470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA179451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty