Provider Demographics
NPI:1730234311
Name:MASON, RICHARD J (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:MASON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7439 E EARLL DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7933
Mailing Address - Country:US
Mailing Address - Phone:480-941-5674
Mailing Address - Fax:
Practice Address - Street 1:7439 E EARLL DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7933
Practice Address - Country:US
Practice Address - Phone:480-941-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2382122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist