Organization
KERVIN MACK DMD MS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERVIN MACK DMD, MS (OWNER)
(336) 227-5594
Entity
Organization
Contact information
Practice address
1628 MEMORIAL DR STE C, BURLINGTON, NC 27215-3596
(336) 227-5594
Mailing address
1628 MEMORIAL DR STE C, BURLINGTON, NC 27215-3596
(336) 227-5594
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8824
NC
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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