# DAVID R. MACK, DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346502598
- **Authorized official:** DR. DAVID RAY MAICK (OWNER)
- **Authorized official phone:** (402) 291-4468

## Contact information

- **Practice address:** 11536 S 31ST ST, BELLEVUE, NE 68123-5529
- **Practice address phone:** (402) 291-4468
- **Practice address fax:** (402) 933-2014
- **Mailing address:** 11536 S 31ST ST, BELLEVUE, NE 68123-5529
- **Mailing address phone:** (402) 291-4468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 06/13/2012
- **Last updated:** 06/13/2012