CHARLES M MALLOY DMD - NPI 1831274406 - Dentist in Portland, OR

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223P0700X and a focus in Prosthodontics.

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About Charles M Malloy Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES M MALLOY DMD (NPI 1831274406) is an individual prosthodontics provider in Portland, Oregon, licensed in Oregon (D7264) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1831274406

Entity TypeIndividualMale

Primary Taxonomy1223P0700X

Provider Legal NameCHARLES M MALLOYCredential: DMD

Location Address2730 SW MOODY AVENUEPortland, OR 97201-5042

Mailing Address13685 Sw Aerie DrPortland, OR 97223-2805 · (503) 579-8203

Phone(503) 494-4316

Fax(503) 494-2365

Sole ProprietorYes

Enumeration DateOctober 25, 2006

Last NPPES UpdateJuly 16, 2014

✔ NPI 1831274406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · ProsthodonticsDental Providers

Taxonomy Code1223P0700X

License✔ Licensed in OR · D7264

Definition

That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.

2730 SW MOODY AVENUE, Portland, OR 97201

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