Provider Demographics
NPI:1821635152
Name:K & H MASON PC
Entity Type:Organization
Organization Name:K & H MASON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-348-5610
Mailing Address - Street 1:317 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:STRATTON
Mailing Address - State:CO
Mailing Address - Zip Code:80836-1155
Mailing Address - Country:US
Mailing Address - Phone:719-348-5610
Mailing Address - Fax:
Practice Address - Street 1:317 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:STRATTON
Practice Address - State:CO
Practice Address - Zip Code:80836-1155
Practice Address - Country:US
Practice Address - Phone:719-348-5610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000158760Medicaid