Individual
THANH T MOLLICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., PA-C
Contact information
Practice address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1000
Mailing address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.024762
OH
122300000X
Dentist
RES3745
OH
363A00000X
Physician Assistant
50-002308
OH
Other
Enumeration date
11/07/2005
Last updated
12/02/2021
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