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Contact Information

JOHN R MALLYA, DMD
579TH DENTAL SQUADRON
BOLLING AFB
APO, AA20332
 Phone: 484-266-9537
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JOHN R MALLYA · (Male)

NPI Number 1942438486
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 06/23/2009
Last updated 06/23/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • PA License # DS037936
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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