Mackenzie Park

Dentist · Brockton, MA

Individual Active NPI

NPI number 1033892559

Practice location

698 Crescent St
Brockton, MA 02302-3360
Phone
(508) 583-2256

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NPI record

NPI
1033892559
Entity type
Individual (Type 1)
Enumeration date
August 10, 2023
Last updated
August 10, 2023
Certified
June 6, 2023
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DN1859934 MA

Mailing address

802 W Clinton St
Elmira, NY 14905-2108

About Mackenzie Park

Mackenzie Park is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 698 Crescent St, Brockton, MA 02302-3360. The NPI number 1033892559 was assigned on August 10, 2023 and the record was last updated on August 10, 2023.

Mackenzie Park lists a license in the registry: #DN1859934 (MA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mackenzie Park?

The NPI number is 1033892559.

What is the phone number of Mackenzie Park?

The phone number listed for the practice location is (508) 583-2256.

Where is Mackenzie Park located?

698 Crescent St, Brockton, MA 02302-3360.

What is the taxonomy code for Mackenzie Park?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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