Organization Name: | BARBARA MALLONEE, DDS, INC |
NPI Number: | 1518373273 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARBARA LYNN MALLONEE (DENTIST/OWNER) |
Mailing Address: | 2121 E Coast Hwy Suite 140 Corona Del Mar |
State: | CA US |
Postal Code: | 926251931 |
Phone Number: | 9496400222 |
Fax Number: | 9496400333 |
NPI Enumeration Date: | 07/02/2014 |
NPI Last Update Date: | 07/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | 29167 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |