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Organization
DR MASON DMD INC
Active
Organization
DR MASON DMD INC
Active
Other names
Dr. Brenton Mason
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENTON M MASON DMD (PRESIDENT)
(505) 821-1430
Entity
Organization
Contact information
Practice address
7007 WYOMING BLVD NE, SUITE B-2, ALBUQUERQUE, NM 87109-3987
(505) 821-1430
(505) 821-1442
Mailing address
7007 WYOMING BLVD NE, SUITE B-2, ALBUQUERQUE, NM 87109-3987
(505) 821-1430
(505) 821-1442
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DD2155
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15740
—
NM
Enumeration date
04/01/2008
Last updated
04/01/2008
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