Mason, Brenton Matthew
Mason, Brenton Matthew is an individual health care provider with primary practice located at 7007 Wyoming Blvd Ne Ste B-2, Albuquerque NM 87109-3987. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mason, Brenton Matthew can be contacted via phone (505) 237-0222.Contact Information
Primary practice address
7007 Wyoming Blvd Ne Ste B-2
Albuquerque NM 87109-3987
Phone: (505) 237-0222
Fax: (505) 821-1442
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DD2155 | New Mexico |
Profile Details
| NPI number | 1336138031 |
|---|---|
| LBN Legal business name | Mason, Brenton Matthew |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336138031 | NPPES |
| New Mexico | MEDICAID | 15740 |
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