Provider Demographics
NPI:1932231529
Name:MASSI, PETER STEPHEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:STEPHEN
Last Name:MASSI
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 1:210 OLD CAMPION RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1635
Mailing Address - Country:US
Mailing Address - Phone:315-724-8216
Mailing Address - Fax:315-724-8217
Practice Address - Street 1:210 OLD CAMPION RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1635
Practice Address - Country:US
Practice Address - Phone:315-724-8216
Practice Address - Fax:315-724-8217
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0375801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice