Provider Demographics
NPI:1588602635
Name:GM DENTAL, PC
Entity Type:Organization
Organization Name:GM DENTAL, PC
Other - Org Name:GHINA C. MALIHA, D.M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GHINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MALIHA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-222-3445
Mailing Address - Street 1:302 N WASHINGTON AVE
Mailing Address - Street 2:SUITE 102 W
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2448
Mailing Address - Country:US
Mailing Address - Phone:856-222-3445
Mailing Address - Fax:856-222-3446
Practice Address - Street 1:302 N WASHINGTON AVE
Practice Address - Street 2:SUITE 102 W
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2448
Practice Address - Country:US
Practice Address - Phone:856-222-3445
Practice Address - Fax:856-222-3446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI018486001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty