Individual
JASMINE MONIQUE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
34 BRUNSWICK ST, BYHALIA, MS 38611-7000
(662) 838-6898
(662) 838-6903
Mailing address
10886 COUNTY ROAD 44, LINDEN, AL 36748-4137
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4361-23
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2022
Last updated
06/13/2023
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