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THOMAS MICHAEL MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
17215 N 72ND DR, STE A100, GLENDALE, AZ 85308
(623) 582-8384
(623) 582-1722
Mailing address
17215 N 72ND DR, STE A100, GLENDALE, AZ 85308
(623) 582-8384
(623) 582-1722

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1682
NM
1223G0001X
General Practice Dentistry
3681
SC
1223G0001X
General Practice Dentistry
Primary
3872
AZ

Other

Enumeration date
09/07/2006
Last updated
07/08/2007
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