Individual
DR. HARRY RUSSELL MACK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,MD
Contact information
Practice address
5802 NOLENSVILLE PIKE, SUITE #103, NASHVILLE, TN 37211-6520
(615) 873-4495
(615) 873-4436
Mailing address
5802 NOLENSVILLE PIKE, SUITE #103, NASHVILLE, TN 37211-6520
(615) 873-4495
(615) 873-4436
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4873
TN
Other
Enumeration date
10/03/2006
Last updated
05/28/2014
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