Individual
DR. MALLORY CHARGING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
202 E GRAND AVE, WITTENBERG, WI 54499-7600
(715) 253-3200
Mailing address
202 E GRAND AVE, WITTENBERG, WI 54499-7600
(715) 253-3200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001102
WI
Other
Enumeration date
05/28/2015
Last updated
05/21/2019
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