Mack, David Ray
Mack, David Ray is an sole proprietor health care provider with primary practice located at 11536 S 31St St , Bellevue NE 68123-5529. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mack, David Ray can be contacted via phone (402) 291-4468.Contact Information
Primary practice address
11536 S 31St St
Bellevue NE 68123-5529
Phone: (402) 291-4468
Fax: (402) 933-2014
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 6375 | Nebraska |
Profile Details
| NPI number | 1205944923 |
|---|---|
| LBN Legal business name | Mack, David Ray |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205944923 | NPPES |
| Nebraska | MEDICAID | 10025213600 |
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