Mark Andrew Mallett, DDS
Dentist in Conway, AR. Individual provider (NPI-1).
NPI number1962071936
StatusActive
Last updated in NPPESJun 23, 2021
Details
- NPI
- 1962071936
- Entity type
- Individual (NPI-1)
- Name
- Mark Andrew Mallett
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2021
- Certification date
- Jun 23, 2021
- Last updated
- Jun 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 4524 | AR | Yes |
Practice location
550 Chestnut StConway, AR 72032-5402
Phone 501-329-8754
Mailing address
550 Chestnut StConway, AR 72032-5402
Phone 501-329-8754
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All 14 Dentist providers in Conway · All 3,490 providers in Conway
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