Provider Demographics
NPI:1093152258
Name:DR MICHAEL S MALKA DMD LLC
Entity Type:Organization
Organization Name:DR MICHAEL S MALKA DMD LLC
Other - Org Name:LINDEN DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MALKA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-862-2020
Mailing Address - Street 1:10 N WOOD AVE
Mailing Address - Street 2:STE B
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-5200
Mailing Address - Country:US
Mailing Address - Phone:908-862-2020
Mailing Address - Fax:908-862-7361
Practice Address - Street 1:10 N WOOD AVE
Practice Address - Street 2:STE B
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-5200
Practice Address - Country:US
Practice Address - Phone:908-862-2020
Practice Address - Fax:908-862-7361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty