Marie Mallory DDS

NPI 1083812556 - Dentist - 122300000X

NPI Details
NPI 1083812556
Gender Female
Enumeration Date 07/06/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
76 DOCTORS PARK DRIVE
SANTA ROSA CA, 95405-6615, US
Phone (707) 542-7800
Fax
Business Location
76 DOCTORS PARK DR
SANTA ROSA CA, 95405-6615, US
Phone (707) 542-7800
Fax
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 43815
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According to our database, Dr. Marie Mallory DDS NPI is 1083812556, taxonomy code is 122300000X and license number is 43815, license state is located at California. Marie Mallory DDS physically located at 76 Doctors Park Drive, Santa Rosa CA, 95405-6615. NPI Number Marie Mallory DDS has the Individual type.

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1083812556 NPI number is provided on an as is basis without warranty of any kind. 1083812556 is maintained by the National Plan & Provider Enumeration System. The contents of Marie Mallory DDS are for informational purposes only.