Simon Lucas Mack, DDS

Dentist in Longview, Texas · NPI 1639676166

Simon Mack is the only dentist we list in Longview, Texas. See all dentists in Texas. Simon Mack practices with East Texas Oral And Maxillofacial Surgery Associates Inc.

Registry record (NPPES)

NPI
1639676166
Type
Type 1 · Individual
Primary taxonomy
Dentist · 122300000X
Address on file
3004 H.G. Mosley Pkwy
Longview, TX 75605
(903) 758-3444
Enumerated
Apr 11, 2018
Record last updated
Sep 9, 2022
License states listed
TX

Medicare (CMS)

Enrollment
Medicare-enrolled in TX
Dentist
Revalidation due
No date set by CMS

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Practice locations

Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.