Provider Demographics
NPI:1730487430
Name:MALLARI, ESTHER NAZARETH (DDS)
Entity type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:NAZARETH
Last Name:MALLARI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2382 CRENSHAW BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3333
Mailing Address - Country:US
Mailing Address - Phone:310-328-1078
Mailing Address - Fax:310-328-1698
Practice Address - Street 1:2382 CRENSHAW BLVD STE A
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3333
Practice Address - Country:US
Practice Address - Phone:310-328-1078
Practice Address - Fax:310-328-1698
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0496OtherDENTIST