# EDWARD C MASSETT JR. DDS APC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154877686
- **Authorized official:** DR. CHRISTOPHER BRADLEY DICKERSON D.D.S., M.D. (OWNER)
- **Authorized official phone:** (985) 641-2030

## Contact information

- **Practice address:** 2334 GAUSE BLVD E, SLIDELL, LA 70461-4141
- **Practice address phone:** (985) 641-2030
- **Practice address fax:** (985) 645-0272
- **Mailing address:** 2334 GAUSE BLVD. EAST, SLIDELL, LA 70461
- **Mailing address phone:** (985) 641-2030
- **Mailing address fax:** (985) 645-0272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2368 | LA | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | LA | — |

## Other

- **Enumeration date:** 08/25/2016
- **Last updated:** 08/25/2016