Provider Demographics
NPI:1255619391
Name:MALAVICH, SCOTT ALLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALLEN
Last Name:MALAVICH
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 1:11438 LEBANON RD UNIT A
Mailing Address - Street 2:RONALD SPRITZER DDS
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-6201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11438 LEBANON RD UNIT A
Practice Address - Street 2:RONALD SPRITZER DDS
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-6201
Practice Address - Country:US
Practice Address - Phone:614-266-2321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30 023510122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist