MEDICARE: DR. AARON J MASON DDS

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	100162215	WI

General Provider Information

NPI Number	:	1972023224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON J MASON DDS

Provider Business Mailing Address
First Line	:	6070 N PORT WASHINGTON RD
Second Line	:
City	:	GLENDALE
State	:	WI
Zip	:	53217-4524
Country	:	US
Telephone Number	:	414-962-4100
Fax Number	:	414-962-0577

Provider Business Practice Location Address
First Line	:	6070 N PORT WASHINGTON RD
Second Line	:
City	:	GLENDALE
State	:	WI
Zip	:	53217-4524
Country	:	US
Telephone Number	:	414-962-4100
Fax Number	:	414-962-0577

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

Provider Enumeration Date	:	06/27/2017
Last Update Date	:	07/21/2022

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