Individual
AYSHA MARIE ROSSMAN-MALLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1254 N WELLS ST, CHICAGO, IL 60610-1981
(312) 337-3300
Mailing address
2925 N TALMAN AVE, CHICAGO, IL 60618-7814
(773) 951-6952
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.014564
—
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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