Provider Demographics
NPI:1639467111
Name:GARSHNICK, MALLORY HOPE (DMD)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:HOPE
Last Name:GARSHNICK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 SE 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8312
Mailing Address - Country:US
Mailing Address - Phone:352-732-8544
Mailing Address - Fax:
Practice Address - Street 1:1910 SE 18TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8312
Practice Address - Country:US
Practice Address - Phone:352-572-7737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602251871223G0001X
FLDN194611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice