Individual
DR. HEATHER ANNE MALLORY-MAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2351 COUNTRYWOOD DR SE, SUITE A, KENTWOOD, MI 49508-5065
(616) 455-0720
(616) 455-0815
Mailing address
3340 BRETON CREEK CT SE, KENTWOOD, MI 49512-9088
(616) 954-9899
(616) 455-0815
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15089
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3142313
—
MI
01
—
J150530
BLUE CROSS PIN
MI
Enumeration date
07/24/2006
Last updated
07/08/2007
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