Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kelly Wade Mack, DDS

Individual provider General Practice Dentistry · NPI 1780702472

Dr. Kelly Wade Mack, DDS is a General Practice Dentistry in Longview, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2007
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

2200 Horseshoe Ln
Longview, TX 75605-5648
Phone: (903) 753-3673
Fax: (903) 753-2637
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 12211 (TX)

Record details

NPI number1780702472
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedMarch 27, 2007
Last updated in NPPESJuly 8, 2007
Mailing address2200 Horseshoe Ln, Longview, TX 75605-5648

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