Individual
TALISHA A MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8061 ALAMEDA AVE, EL PASO, TX 79915-4705
(915) 859-7545
Mailing address
8061 ALAMEDA AVE, EL PASO, TX 79915-4705
(915) 859-7545
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
23639
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130880104
GROUP MEDICAID
TX
01
—
1831267079
GROUP NPI
TX
01
—
451901
GROUP MEDICARE
TX
Enumeration date
11/27/2007
Last updated
12/23/2011
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