Individual
DR. MICHAEL JOHN MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
40 E. PUTNAM AVE., COS COB, CT 06807
(203) 661-2279
(203) 869-2261
Mailing address
40 E. PUTNAM AVE., COS COB, CT 06807
(203) 661-2279
(203) 869-2261
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
005247
CT
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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