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General NPI Number Information
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NPI Number | 1679729016
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Entity Type | Organization
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Legal Business Name | HARRY R. MACK, JR., D.D.S., M.D., LLC
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 06/10/2015
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Provider Practice Location Address
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Address Line | 5802 NOLENSVILLE PIKE SUITE 103
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City | NASHVILLE
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State | TN
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Zip | 37211-6520
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Country | US
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Telephone | 615-832-5599
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Fax | 615-834-4579
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Provider Business Mailing Address
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Address Line | 5802 NOLENSVILLE PIKE SUITE 103
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City | NASHVILLE
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State | TN
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Zip | 37211-6520
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Country | US
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Telephone | 615-873-4495
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Fax | 615-873-4436
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TRACY FLOWERS
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Credential |
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Telephone | 615-873-4495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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