Individual
ROBERT D MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1324 23RD ST S, FARGO, ND 58103-3702
(701) 237-5616
(701) 271-8813
Mailing address
1324 23RD ST S, FARGO, ND 58103-3702
(701) 237-5616
(701) 271-8813
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12682
MN
Other
Enumeration date
05/26/2009
Last updated
05/21/2014
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