MEDICARE: DR. G MASON JONES DDS, MS

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	122300000X	Dentist	18751	TX
2	1223G0001X	General Practice Dentistry	18751	TX
3	1223P0700X	Prosthodontics	18751	TX

General Provider Information

NPI Number	:	1760406953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. G MASON JONES DDS, MS

Provider Business Mailing Address
First Line	:	PO BOX 10068
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77206-0068
Country	:	US
Telephone Number	:	713-812-8080
Fax Number	:

Provider Business Practice Location Address
First Line	:	1343 W 43RD ST
Second Line	:	SUITE F
City	:	HOUSTON
State	:	TX
Zip	:	77018-4200
Country	:	US
Telephone Number	:	713-812-8080
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	08/27/2008

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