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General NPI Number Information
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NPI Number | 1568510329
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Entity Type | Individual
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Provider Name | MASON BRADLEY YEARY DDS
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 1312 VILLAGE CREEK DR #1100
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City | PLANO
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State | TX
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Zip | 75093-4467
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Country | US
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Telephone | 972-231-7216
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Fax | 972-234-0390
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Provider Business Mailing Address
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Address Line | 1312 VILLAGE CREEK DR #1100
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City | PLANO
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State | TX
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Zip | 75093-4467
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Country | US
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Telephone | 972-231-7216
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Fax | 972-234-0390
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14381
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License Number State | TX
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