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General NPI Number Information
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NPI Number | 1629467113
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Entity Type | Organization
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Legal Business Name | ANN MALOTKY, DDS., INC.
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 1800 BUENAVENTURA BLVD SUITE 100
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City | REDDING
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State | CA
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Zip | 96001-3700
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Country | US
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Telephone | 530-243-8806
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Fax | 530-638-8866
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Provider Business Mailing Address
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Address Line | 1800 BUENAVENTURA BLVD SUITE 100
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City | REDDING
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State | CA
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Zip | 96001-3700
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Country | US
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Telephone | 530-243-8806
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Fax | 530-638-8866
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Authorized Official
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Title or Position | DENTIS
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Name | DR. ANN MALOTKY
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Credential | DDS
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Telephone | 530-243-8806
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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 | 032442
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License Number State | CA
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