Organization
MICHAEL H MASON DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL HUGH MASON DDS PA (PRESIDENT)
(505) 984-1827
Entity
Organization
Contact information
Practice address
1456 ST FRANCIS, SANTA FE, NM 87505-4038
(505) 984-1827
(505) 984-1374
Mailing address
1456 ST FRANCIS, SANTA FE, NM 87505-4038
(505) 984-1827
(505) 984-1374
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1161
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004082
DORAL
—
05
—
81836
—
NM
Enumeration date
12/11/2006
Last updated
08/22/2020
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