Provider Demographics
NPI:1760641849
Name:MACKAY, MARY E (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:MACKAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 S LUBEC RD
Mailing Address - Street 2:
Mailing Address - City:LUBEC
Mailing Address - State:ME
Mailing Address - Zip Code:04652-3620
Mailing Address - Country:US
Mailing Address - Phone:207-733-5541
Mailing Address - Fax:207-733-2127
Practice Address - Street 1:43 S LUBEC RD
Practice Address - Street 2:
Practice Address - City:LUBEC
Practice Address - State:ME
Practice Address - Zip Code:04652-3620
Practice Address - Country:US
Practice Address - Phone:207-733-5541
Practice Address - Fax:207-733-2127
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5894122300000X
MEDEN4216122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist