DR. Kelly Wade Mack, DDS
NPI #1780702472 in Longview, Texas
Provider Information
- NPI Number
- 1780702472
- Entity Type
- Individual
- Name
- DR. Kelly Wade Mack, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Mar 27, 2007
- Last Updated
- Jul 8, 2007
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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