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General NPI Number Information
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NPI Number | 1760711527
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Entity Type | Individual
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Provider Name | LANCE EDISON MASON D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 01/18/2010
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Provider Practice Location Address
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Address Line | 1805 E CABRILLO BLVD STE A
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City | SANTA BARBARA
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State | CA
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Zip | 93108-2884
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Country | US
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Telephone | 805-969-5767
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 CALLE CERRITO
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City | SANTA BARBARA
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State | CA
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Zip | 93101-4966
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Country | US
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Telephone | 805-910-5491
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 23639
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License Number State | CA
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