Provider Demographics
NPI:1689057473
Name:JOANNE MALEK
Entity Type:Organization
Organization Name:JOANNE MALEK
Other - Org Name:RDHHEALTHYSMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTAL HYGIENIST
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-759-4397
Mailing Address - Street 1:S68W12662 BRISTLECONE LN
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-3503
Mailing Address - Country:US
Mailing Address - Phone:414-759-4397
Mailing Address - Fax:
Practice Address - Street 1:S68W12662 BRISTLECONE LN
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-3503
Practice Address - Country:US
Practice Address - Phone:414-759-4397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3093016124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty