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General NPI Number Information
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NPI Number | 1164620241
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Entity Type | Organization
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Legal Business Name | DRS.MALIK&MALIK
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 805 E MOCKINGBIRD LN SUITE D
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City | VICTORIA
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State | TX
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Zip | 77904-2145
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Country | US
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Telephone | 361-578-0381
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Fax | 361-578-7794
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Provider Business Mailing Address
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Address Line | 805 E MOCKINGBIRD LN SUITE D
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City | VICTORIA
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State | TX
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Zip | 77904-2145
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Country | US
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Telephone | 361-578-0381
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Fax | 361-578-7794
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Authorized Official
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Title or Position | DR. MARTHA MANLEY MALIK
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Name | DR. MARTHA MANLEY MALIK
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Credential | D.D.S.
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Telephone | 361-578-0381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12860
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License Number State | TX
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