Individual
JOHNNY MASON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1502 S 1ST ST, DIBOLL, TX 75941-9668
(936) 829-2616
Mailing address
1502 S 1ST ST, DIBOLL, TX 75941-9668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13551
TX
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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