Individual
DR. JUSTIN MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
650 W BALTIMORE ST RM 3218, BALTIMORE, MD 21201-1510
(901) 834-2166
Mailing address
650 W BALTIMORE ST RM 3218, BALTIMORE, MD 21201-1510
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
17862
MD
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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