| Edward C Massett Jr. Dds Apc | |
|
2334 Gause Blvd E Slidell LA 70461-4141 | |
| (985) 641-2030 | |
| (985) 645-0272 |
| Full Name | Edward C Massett Jr. Dds Apc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2334 Gause Blvd E, Slidell, Louisiana |
| Authorized Official Name and Position | Christopher Bradley Dickerson (OWNER) |
| Authorized Official Contact | 9856412030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward C Massett Jr. Dds Apc 2334 Gause Blvd. East Slidell LA 70461 Ph: (985) 641-2030 | Edward C Massett Jr. Dds Apc 2334 Gause Blvd E Slidell LA 70461-4141 Ph: (985) 641-2030 |
| NPI Number | 1154877686 |
|---|---|
| Provider Enumeration Date | 08/25/2016 |
| Last Update Date | 08/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154877686 | NPI | - | NPPES |
| 1823686 | Medicaid | LA | |
| 1857149 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2368 (Louisiana) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Louisiana) | Secondary |
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