Provider Demographics
NPI:1760850176
Name:MALHOTRA, REEFAT (DMD)
Entity Type:Individual
Prefix:DR
First Name:REEFAT
Middle Name:
Last Name:MALHOTRA
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 1:295 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01267-2610
Mailing Address - Country:US
Mailing Address - Phone:413-329-9906
Mailing Address - Fax:
Practice Address - Street 1:89 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3009
Practice Address - Country:US
Practice Address - Phone:203-850-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11495122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist