Provider Demographics
NPI:1952490070
Name:MALIN, CRAIG J (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:J
Last Name:MALIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 CARLSBAD VILLAGE DR STE I
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1958
Mailing Address - Country:US
Mailing Address - Phone:760-729-0342
Mailing Address - Fax:
Practice Address - Street 1:1207 CARLSBAD VILLAGE DR STE I
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1958
Practice Address - Country:US
Practice Address - Phone:760-729-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA372951223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics