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General NPI Number Information
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NPI Number | 1619417615
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Entity Type | Organization
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Legal Business Name | MALEEH ORTHODONTICS DDS MS, INC.
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 12587 HESPERIA RD STE A
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City | VICTORVILLE
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State | CA
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Zip | 92395-8308
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Country | US
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Telephone | 760-964-8963
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Fax |
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Provider Business Mailing Address
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Address Line | 20139 YUCCA LOMA RD
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City | APPLE VALLEY
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State | CA
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Zip | 92307-5626
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Country | US
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Telephone | 760-964-8963
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. IMAD MALEEH
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Credential | DDS MS
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Telephone | 760-964-8963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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