Provider Demographics
NPI:1679522502
Name:MALIHA, GHINA C (DMD)
Entity Type:Individual
Prefix:DR
First Name:GHINA
Middle Name:C
Last Name:MALIHA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 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
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:2006-06-02
Deactivation Code:
Reactivation Date:2006-09-12
Provider Licenses
StateLicense IDTaxonomies
NJ22DI018486001223G0001X
PADS027850L1223G0001X
NY05102211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice