Dr. Susan Regina Mallery
Oral and Maxillofacial Pathology
305 W 12th Ave College Of Dentistry Ohio State University
Columbus
, Ohio 43210-1267
Dr. Susan Regina Mallery
Oral and Maxillofacial Pathology
305 W 12th Ave College Of Dentistry Ohio State University
Columbus
, Ohio 43210-1267
(614) 292-9384
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Susan Regina Mallery
- 305 W 12th Ave College Of Dentistry Ohio State University
- Columbus, OH
- Zip : 43210-1267
- Fax : (614) 292-9384
- Phone : (614) 292-5892
Second Address
- Dr. Susan Regina Mallery
- 305 W 12th Ave College Of Dentistry Ohio State University
- Columbus, OH
- Zip : 43210-1267
- Fax : (614) 292-9384
- Phone : (614) 292-5892
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 30016966 | OH |
National Provider Identifier
| NPI | 1083688865 |
|---|---|
| Provider Name | Dr. Susan Regina Mallery |
| First Address | Columbus, OH 43210-1267 |
| Second Address | Columbus, OH 43210-1267 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/02/2006 |
| Last Update Date | 08/03/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.