Individual
BENJAMIN F MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1003 7TH ST NE, DEVILS LAKE, ND 58301-2719
(701) 662-8191
(701) 662-5757
Mailing address
1003 7TH ST NE, DEVILS LAKE, ND 58301-2719
(701) 662-8191
(701) 662-5757
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2011
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41412
—
ND
Enumeration date
06/14/2007
Last updated
01/13/2009
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