Individual
DR. JOHN WALTHER MULLALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
513 SEMINOLE RD, MUSKEGON, MI 49444
(231) 737-6453
(231) 737-1119
Mailing address
513 SEMINOLE ROAD, MUSKEGON, MI 49444
(231) 737-6453
(231) 737-1119
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9633
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4016930
—
MI
Enumeration date
10/24/2006
Last updated
07/08/2007
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