Provider Demographics
NPI:1780713479
Name:MASON, ROSEMARIE E (DMD)
Entity type:Individual
Prefix:DR
First Name:ROSEMARIE
Middle Name:E
Last Name:MASON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1422
Mailing Address - Country:US
Mailing Address - Phone:845-897-5770
Mailing Address - Fax:845-897-5785
Practice Address - Street 1:5 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1422
Practice Address - Country:US
Practice Address - Phone:845-897-5770
Practice Address - Fax:845-897-5785
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0380411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY57057523OtherPIN