| NPI | 1275022782 |
|---|---|
| Former Name | MALLORY K COCHRAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 104077) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2019-10-15 |