Provider Demographics
NPI:1841393626
Name:MALUEG, LESLIE A (DMD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:MALUEG
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 1:1602 BENJAMIN PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-2015
Mailing Address - Country:US
Mailing Address - Phone:336-288-0010
Mailing Address - Fax:336-217-0171
Practice Address - Street 1:1602 BENJAMIN PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2015
Practice Address - Country:US
Practice Address - Phone:336-288-0010
Practice Address - Fax:336-217-0171
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6505122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist