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General NPI Number Information
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NPI Number | 1750551909
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Entity Type | Organization
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Legal Business Name | RICHARD MALECZ, D.M.D.
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 35 W MAIN ST SUITE 203
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City | DENVILLE
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State | NJ
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Zip | 07834-2174
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Country | US
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Telephone | 973-625-4441
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Fax | 973-625-4046
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Provider Business Mailing Address
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Address Line | 35 W MAIN ST SUITE 203
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City | DENVILLE
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State | NJ
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Zip | 07834-2174
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Country | US
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Telephone | 973-625-4441
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Fax | 973-625-4046
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD MALECZ
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Credential | D.M.D., M.B.A.
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Telephone | 973-625-4441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 11577
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License Number State | NJ
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