Organization
KATIE L MACKEN DDS LLC
Active
Other names
Orchard Grove Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATIE LAUREN MACKEN DDS (DENTIST/OWNER)
(980) 999-0435
Entity
Organization
Contact information
Practice address
1550 N DOBYS BRIDGE RD STE 101, FORT MILL, SC 29715-7626
(980) 999-0435
Mailing address
10806 COVE POINT DR, CHARLOTTE, NC 28278-6944
(410) 303-6893
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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