Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JARED WAYNE MACK, DDS
Active Sole ProprietorMR. JARED WAYNE MACK, DDS is a Oral & Maxillofacial Surgery healthcare provider located in ST GEORGE, Utah. NPI 1306092663 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · ST GEORGE, UT
Registration Details
- NPI Number
- 1306092663
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 18, 2008 (17.997567458174 yrs)
- Last Updated
- Jan 16, 2023
- Licenses
-
57690 (CA)57690 (CA)11959048 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
624 S 1000 E STE 17ST GEORGE, UT, 847905898Browse UT providers · Browse ZIP 84790
- Phone
- 4352896600
- Fax
- 4352896900
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Oral & Maxillofacial Surgery
Other Oral & Maxillofacial Surgery Providers in ST GEORGE, UT
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN HIDEO MIZUKAWA | D.D.S. | 1295831691 |
| DR. JOHN HIDEO MIZUKAWA II | DDS | 1104261023 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.