Individual
MR. CHARLES RUSSELL MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1113 LAKEVIEW DRIVE, FRANKLIN, TN 37067
(615) 790-6213
(615) 790-8440
Mailing address
1113 LAKEVIEW DRIVE, FRANKLIN, TN 37067
(615) 790-6213
(615) 790-8440
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10536
TN
Other
Enumeration date
05/02/2016
Last updated
01/20/2023
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