Individual
MALCOLM JOHN MALLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
568 WEST MAIN ST, DANVILLE, VA 24541
(434) 799-0120
(434) 791-1942
Mailing address
568 WEST MAIN ST, DANVILLE, VA 24541
(434) 799-0120
(434) 791-1942
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401004670
VA
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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