Mr. JARED WAYNE MACK DDS
Individual Provider (NPI-1)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1306092663- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DDS
- Status
- Active
Contact & Location
- Address
- 624 S 1000 E STE 17, ST GEORGE, UT, 847905898
- Phone
- (435) 289-6600
- Fax
- (435) 289-6900
Specialties & Taxonomies
Dentist
License: CA #57690
Dentist, Oral and Maxillofacial Surgery
License: CA #57690
Student in an Organized Health Care Education/Training Program
Dentist, Oral and Maxillofacial Surgery
Primary License: UT #11959048