Individual
DR. KEVIN JOSEPH MALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1900 E MAIN ST, VA ILLIANA HCS (160), DANVILLE, IL 61832-5100
(217) 554-4516
Mailing address
349 W 46TH ST, INDIANAPOLIS, IN 46208-3601
(317) 283-6152
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16373
MA
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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