Provider Demographics
NPI:1487755369
Name:MASSIE, BLAND JR (DMD)
Entity type:Individual
Prefix:DR
First Name:BLAND
Middle Name:
Last Name:MASSIE
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4241 BOONSBORO RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2309
Mailing Address - Country:US
Mailing Address - Phone:434-384-9090
Mailing Address - Fax:
Practice Address - Street 1:4241 BOONSBORO RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2309
Practice Address - Country:US
Practice Address - Phone:434-384-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA73941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice