Individual
DR. EDWARD CHARLES MASSETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2334 GAUSE BLVD EAST, SLIDELL, LA 70461
(985) 641-2030
(985) 645-0272
Mailing address
2334 GAUSE BLVD EAST, SLIDELL, LA 70461
(985) 641-2030
(985) 645-0272
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
2368
LA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2368
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00450504
—
MS
05
—
1823686
—
LA
Enumeration date
12/22/2006
Last updated
02/11/2016
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