Organization
CORE FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY MACK DDS (OWNER)
(620) 240-0565
Entity
Organization
Contact information
Practice address
1217 E MAIN ST, LINN, MO 65051-9634
(573) 897-2388
Mailing address
1217 E MAIN ST, LINN, MO 65051-9634
(573) 897-2388
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2006016427
MO
Other
Enumeration date
04/23/2017
Last updated
04/23/2017
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