Individual
LORI MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
121 W BRANCH ST STE A, ARROYO GRANDE, CA 93420-2601
(805) 481-6617
(805) 481-3829
Mailing address
121 W BRANCH ST STE A, ARROYO GRANDE, CA 93420-2601
(805) 481-6617
(805) 481-3829
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
18017
CA
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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