Edmondson, Mallory
Edmondson, Mallory is an individual health care provider with primary practice located at 1002 S Esther St , South Bend IN 46615-1440. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Edmondson, Mallory can be contacted via phone (219) 363-8866.Contact Information
Primary practice address
1002 S Esther St
South Bend IN 46615-1440
Phone: (219) 363-8866
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 13007311A | Indiana |
Profile Details
| NPI number | 1467920892 |
|---|---|
| LBN Legal business name | Edmondson, Mallory |
| Credentials | MSDH, RDH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2018 |
| Last updated | Nov 3rd, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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