Sds-Bill Owens Pkwy Pllc

NPI #1609349612 in Longview, Texas

Provider Information

NPI Number: 1609349612
Entity Type: Organization
Organization Name: Sds-Bill Owens Pkwy Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 3, 2019
Last Updated: Jan 3, 2019

Practice Location

Address: 3 DOCTOR CIR
City: Longview
State: Texas
ZIP Code: 75605-5050
Phone: (903) 757-2495

Authorized Official

Name: DR. SAMUEL CHRISTOPHER MACK, DDS
Title: MANAGER
Phone: (903) 236-4050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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