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Individual

MASON MINER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
72 SUTTLE ST UNIT H, DURANGO, CO 81303-6829
(970) 247-2677
(970) 382-9581
Mailing address
72 SUTTLE ST UNIT H, DURANGO, CO 81303-6829
(970) 247-2677
(970) 382-9581

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8689
CO
332B00000X
Durable Medical Equipment & Medical Supplies
8689
CO

Other

Enumeration date
03/30/2015
Last updated
10/02/2019
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