Individual
DR. DALE LARRIE MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4867 BAXTER RD, SUITE 101, VIRGINIA BEACH, VA 23462-4469
(757) 499-8139
Mailing address
4867 BAXTER RD, SUITE 101, VIRGINIA BEACH, VA 23462-4469
(757) 499-8139
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005769
VA
Other
Enumeration date
01/14/2007
Last updated
07/08/2007
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