Individual
DR. RAYMOND FRANK MALLINAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
604 E CHURCH ST, MARTINSVILLE, VA 24112-3008
(276) 632-2189
(276) 638-2306
Mailing address
PO BOX 3966, MARTINSVILLE, VA 24115-3966
(276) 632-2189
(276) 638-2306
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005236
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9178603
—
VA
Enumeration date
12/04/2006
Last updated
07/09/2007
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