Whalio Doctors

NPI 1033628920

Mack and Hansen Orthodontics, PLLC

Organisation Orthodontics and Dentofacial Orthopedics Dentistry Longview, TX

Practice location

Address
1405 Judson Rd, Longview, TX 75601-3918
Phone
(903) 212-7737
Fax
(903) 212-7745

Authorised official

Name
Spencer McKenzie Mack
Title
Owner/Orthodontist
Phone
(903) 212-7737

Registered specialties (3)

Orthodontics and Dentofacial Orthopedics Dentistry Primary
Dental Providers Taxonomy 1223X0400X
Dental Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QD0000X
Dental Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence 30007 (TX)

Registry record

NPI
1033628920
Entity type
Organization
NPI issued
24 Sep 2017
Record last updated
4 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.