Provider Demographics
NPI:1821446873
Name:DAVID MALAN DDS, PLLC
Entity Type:Organization
Organization Name:DAVID MALAN DDS, PLLC
Other - Org Name:MALAN FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:MALAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-895-5210
Mailing Address - Street 1:715 S LONG DR
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-4315
Mailing Address - Country:US
Mailing Address - Phone:910-895-5210
Mailing Address - Fax:
Practice Address - Street 1:715 S LONG DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4315
Practice Address - Country:US
Practice Address - Phone:910-895-5210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty