Individual
DR. YVONNE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1011 W LITTLE CREEK RD STE A, NORFOLK, VA 23505-2025
(757) 440-7955
Mailing address
1011 W LITTLE CREEK RD STE A, NORFOLK, VA 23505-2025
(757) 440-7955
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401416872
VA
1223G0001X
General Practice Dentistry
0442000328
VA
390200000X
Student in an Organized Health Care Education/Training Program
0442000328
VA
Other
Enumeration date
07/27/2018
Last updated
06/09/2020
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