Individual
KERRI LYNN MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4010 1ST DIVISION RD, FT RILEY, KS 66442
(785) 239-4174
Mailing address
1534 PATRIOT DR, JUNCTION CITY, KS 66441-1984
(850) 377-6369
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH24313
FL
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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