Individual
ANTHONY MASSARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
7711 BAYMEADOWS RD E STE 7, JACKSONVILLE, FL 32256-9110
(904) 565-1505
Mailing address
906 MAPLETON TER, JACKSONVILLE, FL 32207-5205
(412) 334-0163
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN20307
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN20307
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
712859
—
FL
Enumeration date
05/07/2012
Last updated
03/22/2024
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