Provider Demographics
NPI:1821324807
Name:JASJEET S MALLI DDS INC
Entity Type:Organization
Organization Name:JASJEET S MALLI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASJEET
Authorized Official - Middle Name:S
Authorized Official - Last Name:MALLI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-688-7529
Mailing Address - Street 1:233 N M ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-4138
Mailing Address - Country:US
Mailing Address - Phone:559-688-7529
Mailing Address - Fax:
Practice Address - Street 1:233 N M ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-4138
Practice Address - Country:US
Practice Address - Phone:559-688-7529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty