Provider Demographics
NPI:1225285653
Name:MALOCH, FREDERICK RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:RICHARD
Last Name:MALOCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5212
Mailing Address - Country:US
Mailing Address - Phone:713-797-1731
Mailing Address - Fax:713-526-5689
Practice Address - Street 1:2304 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5212
Practice Address - Country:US
Practice Address - Phone:713-797-1731
Practice Address - Fax:713-526-5689
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX149511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice