Healthcare Provider Details

I. General information

NPI: 1427809045
Provider Name (Legal Business Name): MALIK NOEL WALTERS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 HONEYGO CENTER DR STE 101
PERRY HALL MD
21128-8962
US

IV. Provider business mailing address

5002 HONEYGO CENTER DR STE 101
PERRY HALL MD
21128-8962
US

V. Phone/Fax

Practice location:
  • Phone: 410-248-3384
  • Fax: 410-248-3385
Mailing address:
  • Phone: 410-248-3384
  • Fax: 410-248-3385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number18608
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: