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General NPI Number Information
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NPI Number | 1093109175
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Entity Type | Individual
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Provider Name | MALCOLM EDWARD BEKOFF DDS
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Gender | Male
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 03/31/2015
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Provider Practice Location Address
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Address Line | 4293 ROUTE 47 BAYSIDE STATE PRISON
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City | LEESBURG
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State | NJ
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Zip | 08327
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Country | US
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Telephone | 856-785-0040
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Fax | 856-785-2382
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Provider Business Mailing Address
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Address Line | 4293 ROUTE 47, BAYSIDE STATE PRISON
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City | LEESBURG
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State | NJ
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Zip | 08327
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Country | US
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Telephone | 856-785-0040
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Fax | 856-785-2382
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22D100799600
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License Number State | NJ
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