Nicholas Talbert Mallory, DMD is a
Dentist - General Practice based in Eagar, Arizona. Nicholas Talbert Mallory is licensed to practice in Arizona (license number D010324) and his current practice location is
133 W Central Ave, Eagar, Arizona. He can be reached at his office (for appointments etc.) via phone at
(928) 333-4121.
NPI number for Nicholas Talbert Mallory is 1851950588 and his current mailing address is 150 N River Rd, Eagar, Arizona. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1851950588.
Healthcare Provider's Profile
Full Name | Nicholas Talbert Mallory |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 133 W Central Ave, Eagar, Arizona |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1851950588
- Provider Enumeration Date: 06/06/2019
- Last Update Date: 06/06/2019
Medical Identifiers
Medical identifiers for Nicholas Talbert Mallory such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1851950588 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | D010324 (Arizona) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicholas Talbert Mallory is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Nicholas Talbert Mallory, DMD 150 N River Rd, Eagar, AZ 85925-9899 Ph: () - | Nicholas Talbert Mallory, DMD 133 W Central Ave, Eagar, AZ 85925 Ph: (928) 333-4121 |
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