Mallinak, Laura R

Mallinak, Laura R is an individual health care provider with primary practice located at 604 E Church St , Martinsville VA 24112-3008. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Mallinak, Laura R can be contacted via phone (276) 632-2189.

Contact Information

Primary practice address
604 E Church St Martinsville VA 24112-3008
Phone: (276) 632-2189
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 0401411452 Virginia

Profile Details

NPI number 1558563965
LBN Legal business name Mallinak, Laura R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2007
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1558563965 NPPES
Virginia MEDICAID 9183678

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