MEDICARE: GARN & MASON ORTHODONTICS, PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	5348	AZ

General Provider Information

NPI Number	:	1154382190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARN & MASON ORTHODONTICS, PLC

Provider Business Mailing Address
First Line	:	2835 E BROWN RD
Second Line	:	SUITE 102
City	:	MESA
State	:	AZ
Zip	:	85213-5470
Country	:	US
Telephone Number	:	480-832-3830
Fax Number	:	480-924-9147

Provider Business Practice Location Address
First Line	:	2835 E BROWN RD
Second Line	:	SUITE 102
City	:	MESA
State	:	AZ
Zip	:	85213-5470
Country	:	US
Telephone Number	:	480-832-3830
Fax Number	:	480-924-9147

Authorized Official
Title or Position	:	PARTNER
Name	:	GREGORY GARN
Credential	:	D.D.S.,M.S.
Telephone Number	:	480-832-3830

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	08/19/2020

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