# GRANT S MASON DDS INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GRANT S MASON
- **Other names:** Mason Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215120068
- **Legal business name:** GRANT S MASON
- **Authorized official:** DR. GRANT S MASON DDS (PRESIDENT)
- **Authorized official phone:** (304) 400-4835

## Contact information

- **Practice address:** 3906 MACCORKLE AVE SE, CHARLESTON, WV 25304-1633
- **Practice address phone:** (304) 400-4835
- **Practice address fax:** (304) 681-2058
- **Mailing address:** 3906 MACCORKLE AVE SE, CHARLESTON, WV 25304-1633
- **Mailing address phone:** (304) 400-4835
- **Mailing address fax:** (304) 681-2058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | WV3235 | WV | Yes |

## Other

- **Enumeration date:** 08/24/2007
- **Last updated:** 08/29/2012