Provider Demographics
NPI:1770929796
Name:MASON, BENJAMIN RYAN (DMD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:RYAN
Last Name:MASON
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 1:10615 FRY RD # B1-400
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6975
Mailing Address - Country:US
Mailing Address - Phone:281-826-5900
Mailing Address - Fax:832-334-5451
Practice Address - Street 1:10615 FRY RD # B1-400
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6975
Practice Address - Country:US
Practice Address - Phone:281-826-5900
Practice Address - Fax:832-334-5451
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28237122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist