KELLY WADE MACK

LONGVIEW, TX
NPI1780702472
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: TX  12211)
Enumeration Date2007-03-27
Last Update Date2007-07-08
Business Address
Dr. KELLY WADE MACK dds
2200 HORSESHOE LN
LONGVIEW, TX 75605-5648
Phone number: 903-753-3673
Mailing Address
Dr. KELLY WADE MACK dds
2200 HORSESHOE LN
LONGVIEW, TX 75605-5648
Phone number: 903-753-3673