Individual
MARIA MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-3410
Mailing address
426 SW STARK ST, 9TH FLOOR, PORTLAND, OR 97204-2303
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5460
OR
Other
Enumeration date
06/03/2011
Last updated
06/03/2016
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