Individual
DR. CHRISTOPHER EARL MALLOY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1067 HWY 95, WEISER, ID 83672
(208) 549-0838
Mailing address
1071 HIWAY 95, WEISER, ID 83672-5566
(208) 549-0838
(208) 549-2296
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1893
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019569
—
ID
Enumeration date
01/18/2006
Last updated
07/08/2007
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