Individual
ANTHONY GABRIEL MASSARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
320 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-5102
Mailing address
858 GOODALE DR, AUGUSTA, GA 30909-0709
(954) 299-6577
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN26095
FL
390200000X
Student in an Organized Health Care Education/Training Program
DN26095
FL
Other
Enumeration date
07/21/2021
Last updated
08/14/2023
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