Corey Mack, D.D.S.
Individual provider Active NPI General Practice Dentistry · Linn, MO
NPI 1962541995 · NPPES record last updated Nov 29, 2023
Key facts
- NPI
- 1962541995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2006016427 (MO)
- Practice address
- 1217 East Main
Linn, MO 65051 - Phone
- (573) 897-2388
- Fax
- (573) 897-3816
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006016427 | MO | MD | General Practice Dentistry |
| 13-2006 | NM | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Family Dentistry LLC | General Practice | Past |
Accepting new patients |
| Carney & Ambrose, DDS, LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13-2006 | NM | |
| General Practice Dentistry | 1223G0001X | 2006016427 | MO | Yes |
Addresses
Primary practice location
1217 East Main
Linn, MO 65051
Mailing address
PO Box 1219
1217 East Main St
Linn, MO 65051
Phone (573) 897-2388
Other names
- Corey Frey
Other providers in Linn, MO
- Sara Marie King
- Madison Lehmen
- Linn Community Skilled Care, LLC
- Linn Living & Rehab Center, LLC
- Alycia Ann Maasen
- Karla Lisetta McKim
- Christen Muenks
- Kara Lynn Neihart
- Osage Ambulance District
- Osage Co R-II
All providers in Linn, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.