DR. Mark Ray Mallett, D.D.S

NPI #1043427289 in Los Alamitos, California

Provider Information

NPI Number: 1043427289
Entity Type: Individual
Name: DR. Mark Ray Mallett, D.D.S
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S
Enumeration Date: May 17, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 3551 FARQUHAR AVE
Address 2: SUITE 103
City: Los Alamitos
State: California
ZIP Code: 90720-2003
Phone: (562) 596-1655

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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