Provider Demographics
NPI:1437751633
Name:MASON, SHERRY (REGISTERED DENTAL HY)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:REGISTERED DENTAL HY
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:SMITHSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED DENTAL HY
Mailing Address - Street 1:2532 CANTERBURY DR N
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1316
Mailing Address - Country:US
Mailing Address - Phone:561-215-5519
Mailing Address - Fax:
Practice Address - Street 1:1515 N FLAGLER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3429
Practice Address - Country:US
Practice Address - Phone:561-659-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH7893124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist