Provider Demographics
NPI:1437470960
Name:MALONE, MICHELLE E (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:E
Last Name:MALONE
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 1:909 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-2916
Mailing Address - Country:US
Mailing Address - Phone:620-343-9220
Mailing Address - Fax:620-343-9221
Practice Address - Street 1:909 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2916
Practice Address - Country:US
Practice Address - Phone:620-343-9220
Practice Address - Fax:620-343-9221
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist