Provider Demographics
NPI:1720179369
Name:MALOUF, RONALD PHILLIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:PHILLIP
Last Name:MALOUF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2403
Mailing Address - Country:US
Mailing Address - Phone:714-827-4990
Mailing Address - Fax:714-827-8943
Practice Address - Street 1:9201 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-2403
Practice Address - Country:US
Practice Address - Phone:714-827-4990
Practice Address - Fax:714-827-8943
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19360122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist