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1831274406
CHARLES M MALLOY
PORTLAND, OR
NPI
1831274406
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0700X Dentist, Prosthodontics
(Licence: OR D7264)
Enumeration Date
2006-10-25
Last Update Date
2014-07-16
Business Address
-- CHARLES M MALLOY DMD
2730 SW MOODY AVENUE
PORTLAND, OR 97201-5042
Phone number: 503-494-4316
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Mailing Address
-- CHARLES M MALLOY DMD
13685 SW AERIE DR
PORTLAND, OR 97223-2805
Phone number: 503-579-8203
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