# MASON DENTAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104993484
- **Authorized official:** TAMARA LYNN BAUER MONDRAGON DDS (PRESIDENT OWNER)
- **Authorized official phone:** (517) 676-1091

## Contact information

- **Practice address:** 782 E COLUMBIA STREET, MASON, MI 48854-1356
- **Practice address phone:** (517) 676-1091
- **Practice address fax:** (517) 676-4954
- **Mailing address:** 782 E COLUMBIA STREET, MASON, MI 48854-1356
- **Mailing address phone:** (517) 676-1091
- **Mailing address fax:** (517) 676-4954

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901015785 | MI | Yes |

## Other

- **Enumeration date:** 11/29/2006
- **Last updated:** 08/22/2020