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General NPI Number Information
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NPI Number | 1245269422
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Entity Type | Individual
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Provider Name | DIDIER-DAVID ANTOINE MALIS D.M.D., M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6550 FANNIN ST 2237
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City | HOUSTON
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State | TX
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Zip | 77030-2717
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Country | US
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Telephone | 713-790-4600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 201088
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City | HOUSTON
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State | TX
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Zip | 77216-1088
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Country | US
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Telephone | 713-500-3500
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Fax | 713-500-5484
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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 | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | F22203
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License Number State | TX
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