Individual
DR. MATTHEW P MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1420 DICKERSON ST, NEWARK, OH 43055-1844
(740) 344-9155
(740) 344-5668
Mailing address
13577 CHURCH VIEW CT, PICKERINGTON, OH 43147
(614) 834-4813
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30021474
OH
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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