Provider Demographics
NPI:1912380577
Name:DUFF, MASON ROBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:MASON
Middle Name:ROBERT
Last Name:DUFF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9061 W POST RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2411
Mailing Address - Country:US
Mailing Address - Phone:702-434-4800
Mailing Address - Fax:702-433-4806
Practice Address - Street 1:10670 DEAN MARTIN DR STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3597
Practice Address - Country:US
Practice Address - Phone:702-680-1120
Practice Address - Fax:702-680-1118
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6643122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist