Individual
DR. HOBERT L MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
505 STRATTON ST, LOGAN, WV 25601-3806
(304) 752-3563
(304) 752-3148
Mailing address
505 STRATTON ST, LOGAN, WV 25601-3806
(304) 752-3563
(304) 752-3148
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2429
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137436000
—
WV
Enumeration date
08/31/2006
Last updated
07/08/2007
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