Individual
DR. MALLORY MARQUIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
232 W 61ST ST, NEW YORK, NY 10023-7803
(646) 558-6058
Mailing address
232 W 61ST ST, NEW YORK, NY 10023-7803
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
058668
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/11/2015
Last updated
07/27/2016
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