MEDICARE: JOHN ANTHONY MASON DMD

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	1223G0001X	General Practice Dentistry	DN12116	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851370456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ANTHONY MASON DMD

Provider Business Mailing Address
First Line	:	3308 S DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-7818
Country	:	US
Telephone Number	:	813-835-0090
Fax Number	:	813-835-0638

Provider Business Practice Location Address
First Line	:	3308 S DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-7818
Country	:	US
Telephone Number	:	813-835-0090
Fax Number	:	813-835-0638

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	07/09/2007

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