Male or Other

Mackenzie Park

Dentist in Brockton, MA(View on Map)

Full Name

Mackenzie Park

NPI Number

1033892559

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/10/2023

Specialties

(Taxonomies)

Name

Code

122300000X

Primary Taxonomy

Yes

Licenses

State

Massachusetts

License Number

DN1859934

Contact
Information

Purpose

Mailing
Location

Address

802 W CLINTON ST
698 CRESCENT ST

City

Elmira
Brockton

State

NY
MA

Postal Code

14905-2108
02302-3360

Country

US
US

Telephone Number

N/A
(508) 583-2256

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/10/2023

Provider Address

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