Organization
RAYMOND F. MALLINAK, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND FRANK MALLINAK DDS (OWNER)
(276) 632-2189
Entity
Organization
Contact information
Practice address
604 E CHURCH ST, MARTINSVILLE, VA 24112-3008
(276) 632-2189
(276) 638-2306
Mailing address
PO BOX 3966, MARTINSVILLE, VA 24115-3966
(276) 632-2189
(276) 638-2306
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005236
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9178603
—
VA
Enumeration date
10/15/2009
Last updated
10/15/2009
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