MEDICARE: DR. DONALD HENRY MALNOFSKI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30012063	OH

General Provider Information

NPI Number	:	1770687055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD HENRY MALNOFSKI DDS

Provider Business Mailing Address
First Line	:	11497 SPRINGFIELD PIKE
Second Line	:	SUITE 2
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3551
Country	:	US
Telephone Number	:	513-772-2396
Fax Number	:	513-772-2399

Provider Business Practice Location Address
First Line	:	11497 SPRINGFIELD PIKE
Second Line	:	SUITE 2
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3551
Country	:	US
Telephone Number	:	513-772-2396
Fax Number	:	513-772-2399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	07/08/2007

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