Organization
MACK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA ADKISSON (BUSINESS MANAGER)
(903) 236-4050
Entity
Organization
Contact information
Practice address
3008 H G MOSLEY PKWY, LONGVIEW, TX 75605-2948
(903) 236-4050
(903) 753-4426
Mailing address
3008 H G MOSLEY PKWY, LONGVIEW, TX 75605-2948
(903) 236-4050
(903) 753-4426
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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