Masenior, Jeremy Keith

Masenior, Jeremy Keith is an individual health care provider with primary practice located at 12165 Elm St , Princess Anne MD 21853-1358. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / General Practice is his primary health care specialty. Masenior, Jeremy Keith can be contacted via phone (410) 651-5151.

Contact Information

Primary practice address
12165 Elm St Princess Anne MD 21853-1358
Phone: (410) 651-5151
Fax: (410) 651-4256
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 15315 Maryland
Dental Providers / Dentist 122300000X DT2403 Hawaii

Profile Details

NPI number 1740508613
LBN Legal business name Masenior, Jeremy Keith
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2010
Last updated Mar 14th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740508613 NPPES
Maryland MEDICAID 119591300

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