Individual
DR. CHRISTOPHER STEPHEN MALLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9030 PETERSBURG PIKE, UPPER TRACT, WV 26866-8014
(304) 358-7284
Mailing address
8791 PETERSBURG PIKE, UPPER TRACT, WV 26866-8016
(304) 358-2887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4405
WV
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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