Mack, Jacob

Mack, Jacob is an individual health care provider with primary practice located at 4175 S Alamo Ave , Davis Monthan Afb AZ 85707-4402. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Student, Health Care / Student in an Organized Health Care Education/Training Program. Dental Providers / General Practice is his primary health care specialty. Mack, Jacob can be contacted via phone (719) 333-5192.

Contact Information

Primary practice address
4175 S Alamo Ave Davis Monthan Afb AZ 85707-4402
Phone: (719) 333-5192
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 66362065 Colorado
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X DEN.00205341 Colorado

Profile Details

NPI number 1003544842
LBN Legal business name Mack, Jacob
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2022
Last updated Jul 24th, 2025 - about last year

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.

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