| Doctor Name: | NICHOLAS A MASSOTH |
| NPI Number: | 1114957917 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.M.D. |
| License Number: | D 3848 OS |
| Business Practice Address: | 4121 Clock Tower Ave Caldwell, ID - 836075006 |
| Business Phone Number: | 2084597800 |
| Business Fax Number: | 2084558452 |
| Mailing Address: | 4121 Clock Tower Ave, CALDWELL |
| State: | ID |
| Postal Code: | 836075006 |
| Phone Number: | 2084597800 |
| Fax Number: | 2084558452 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0106X |
| License Number: | D 3848 OS |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Oral and Maxillofacial Pathology |
| Taxonomy Definition: | The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |