Provider Demographics
NPI:1891964227
Name:JENNIFER S. MASSEY, DDS, PA
Entity Type:Organization
Organization Name:JENNIFER S. MASSEY, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:STALLINGS
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-673-6030
Mailing Address - Street 1:6513 SEVEN LAKES VLG
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9300
Mailing Address - Country:US
Mailing Address - Phone:910-673-6030
Mailing Address - Fax:910-673-6031
Practice Address - Street 1:1064 SEVEN LAKES DRIVE
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376
Practice Address - Country:US
Practice Address - Phone:910-673-6030
Practice Address - Fax:910-673-6031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental