Individual
MARK ANDREW MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
550 CHESTNUT ST, CONWAY, AR 72032-5402
(501) 329-8754
Mailing address
550 CHESTNUT ST, CONWAY, AR 72032-5402
(501) 329-8754
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4524
AR
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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