Mark Ray Mallett D.D.S

NPI 1043427289 - Dentist - 122300000X

NPI Details
NPI 1043427289
Gender Male
Enumeration Date 05/17/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
3551 FARQUHAR AVE
SUITE 103
LOS ALAMITOS CA, 90720-2003, US
Phone (562) 596-1655
Fax (562) 799-9599
Business Location
11444 TORTUGA ST
CYPRESS CA, 90630-5304, US
Phone (562) 596-1655
Fax (562) 799-9599
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 19927
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According to our database, Dr. Mark Ray Mallett D.D.S NPI is 1043427289, taxonomy code is 122300000X and license number is 19927, license state is located at California. Mark Ray Mallett D.D.S physically located at 3551 Farquhar Ave, Los Alamitos CA, 90720-2003. NPI Number Mark Ray Mallett D.D.S has the Individual type.

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1043427289 NPI number is provided on an as is basis without warranty of any kind. 1043427289 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Ray Mallett D.D.S are for informational purposes only.