Provider Demographics
NPI:1538288642
Name:LEHMAN, MALCOLM DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:MALCOLM
Middle Name:DAVID
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 BALMORAL DR SW
Mailing Address - Street 2:SUITE C
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6409
Mailing Address - Country:US
Mailing Address - Phone:256-536-9003
Mailing Address - Fax:
Practice Address - Street 1:4101 BALMORAL DR SW
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6409
Practice Address - Country:US
Practice Address - Phone:256-536-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL36831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics