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General NPI Number Information
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NPI Number | 1588978647
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Entity Type | Individual
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Provider Name | SUZANNE ANDERSON MASON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2010
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Last Update Date | 08/01/2010
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Provider Practice Location Address
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Address Line | 1011 N UNIVERSITY AVE UNIV. OF MICHIGAN SCHOOL OF DENTISTRY
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City | ANN ARBOR
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State | MI
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Zip | 48109-1078
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Country | US
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Telephone | 734-763-3325
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Fax |
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Provider Business Mailing Address
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Address Line | 205 N COLONY DR
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City | SAGINAW
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State | MI
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Zip | 48638-7101
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Country | US
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Telephone | 989-909-7836
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Fax |
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2901020212
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License Number State | MI
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