Provider Demographics
NPI:1407060270
Name:MICHAEL D. MASON DDS
Entity Type:Organization
Organization Name:MICHAEL D. MASON DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-424-3884
Mailing Address - Street 1:99 ROSEMAR RD
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-7657
Mailing Address - Country:US
Mailing Address - Phone:304-424-3884
Mailing Address - Fax:304-424-3973
Practice Address - Street 1:99 ROSEMAR RD
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-7657
Practice Address - Country:US
Practice Address - Phone:304-424-3884
Practice Address - Fax:304-424-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty