Individual provider · Type 1 NPI

Kelly Wade Mack, DDS

General Practice Dentistry · Longview, TX

NPI number 1780702472 Active

Practice location

2200 Horseshoe Ln
Longview, TX 75605-5648

Call (903) 753-3673 Map

Fax (903) 753-2637

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X12211 (TX)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1780702472

Kelly Wade Mack, DDS's National Provider Identifier is 1780702472, issued on Mar 27, 2007. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Longview, TX. The record was last updated on Jul 8, 2007.