Provider Demographics
NPI:1891801825
Name:MALOO, HUZAIFA H (DDS)
Entity Type:Individual
Prefix:
First Name:HUZAIFA
Middle Name:H
Last Name:MALOO
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 1:7161 ROCKSPRING LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-5460
Mailing Address - Country:US
Mailing Address - Phone:909-863-5489
Mailing Address - Fax:
Practice Address - Street 1:5696 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-4404
Practice Address - Country:US
Practice Address - Phone:951-369-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49372122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist