Individual
JENNIFER MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 E 25TH ST, KANSAS CITY, MO 64108-2716
(816) 235-2147
Mailing address
650 E 25TH ST, KANSAS CITY, MO 64108-2716
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2023046336
MO
122300000X
Dentist
61230
KS
Other
Enumeration date
11/03/2015
Last updated
01/19/2024
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