Nicholas A Massoth
Oral and Maxillofacial Pathology
4121 Clock Tower Ave
Caldwell
, Idaho 83607-5006
Nicholas A Massoth
Oral and Maxillofacial Pathology
4121 Clock Tower Ave
Caldwell
, Idaho 83607-5006
(208) 455-8452
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Nicholas A Massoth
- 4121 Clock Tower Ave
- Caldwell, ID
- Zip : 83607-5006
- Fax : (208) 455-8452
- Phone : (208) 459-7800
Second Address
- Nicholas A Massoth
- 4121 Clock Tower Ave
- Caldwell, ID
- Zip : 83607-5006
- Fax : (208) 455-8452
- Phone : (208) 459-7800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | D 3848 OS | ID |
National Provider Identifier
| NPI | 1114957917 |
|---|---|
| Provider Name | Nicholas A Massoth |
| First Address | Caldwell, ID 83607-5006 |
| Second Address | Caldwell, ID 83607-5006 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/07/2006 |
| Last Update Date | 09/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.