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Dr. Kelly Wade Mack, DDS
General Practice Dentistry in Longview, Texas
NPI 1780702472

Kelly Wade Mack is a General Practice Dentistry based in Longview, TX and is specialized in General Practice. Kelly Wade Mack practices in Longview, TX and has the professional credentials of DDS. The NPI Number for Kelly Wade Mack is 1780702472 and holds a License No. 12211 (Texas).

The current practice location address for Kelly Wade Mack is 2200 Horseshoe Ln, Longview, TX and can be reached out via phone at 903-753-3673 and via fax at 903-753-2637.

Location: 2200 Horseshoe Ln, Longview, TX, 75605-5648
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780702472
Provider Name
Kelly Wade Mack
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2200 Horseshoe Ln, Longview, TX, 75605-5648
Phone Number
903-753-3673
Fax Number
903-753-2637
Provider Enumeration Date
03/27/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2200 Horseshoe Ln
City
Longview
State
Texas
Zip
75605-5648
Phone Number
903-753-3673
Fax Number
903-753-2637
person
Provider Business Mailing Address Details
Address
2200 Horseshoe Ln
City
Longview
State
Texas
Zip
75605-5648
Phone Number
903-753-3673
Fax Number
903-753-2637
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
12211 (Texas)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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