Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KELLY WADE MACK, DDS
Active Sole ProprietorDR. KELLY WADE MACK, DDS is a General Dentistry healthcare provider located in LONGVIEW, Texas. NPI 1780702472 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · LONGVIEW, TX
Registration Details
- NPI Number
- 1780702472
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 27, 2007 (19.396504396249 yrs)
- Last Updated
- Jul 8, 2007
- License
-
12211 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2200 HORSESHOE LNLONGVIEW, TX, 756055648Browse TX providers · Browse ZIP 75605
- Phone
- 9037533673
- Fax
- 9037532637
- Primary Specialty
-
General Dentistry
1223G0001X
Other General Dentistry Providers in LONGVIEW, TX
| Name | Credential | NPI |
|---|---|---|
| DR. KENNETH L STILWELL | D.D.S. | 1336142843 |
| DR. KRISTA SMITH DARR | DDS | 1831191188 |
| DR. JEFFREY TAYLOR SHELTON | D.D.S. | 1831193200 |
| DR. DONALD GATES ONEAL | DDS | 1164498028 |
| DR. BARRY CLINTON BRUYERE | DDS | 1649247891 |
| DR. MARC J MEADOWS | DDS | 1972550630 |
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.