Organization
MALLAIS DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRA SHANNON MALLAIS DDS (OWNER/DENTIST)
(989) 894-4611
Entity
Organization
Contact information
Practice address
1049 N PINE RD, ESSEXVILLE, MI 48732-1915
(989) 894-4611
(989) 894-2669
Mailing address
1049 N PINE RD, ESSEXVILLE, MI 48732-1915
(989) 894-4611
(989) 894-2669
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901020258
MI
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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