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Contact Information

CHARLES M MALLOY, DMD
2730 SW MOODY AVENUE
PORTLAND, OR97201-5042
 Phone: 503-494-4316
 Fax: 503-494-2365
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthodontics

1223P0700X
Indicates primary specialty

NPI Profile & details for CHARLES M MALLOY · (Male)

NPI # 1831274406
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 10/25/2006
Last updated 07/16/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # D7264
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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