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General NPI Number Information
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NPI Number | 1811171465
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Entity Type | Organization
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Legal Business Name | MICHAEL J. MALONEY, D.D.S., P.C.
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 216 TROY SCHENECTADY RD
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City | LATHAM
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State | NY
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Zip | 12110-3425
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Country | US
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Telephone | 518-782-9015
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Fax | 518-782-7341
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Provider Business Mailing Address
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Address Line | 216 TROY SCHENECTADY RD
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City | LATHAM
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State | NY
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Zip | 12110-3425
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Country | US
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Telephone | 518-782-9015
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Fax | 518-782-7341
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Authorized Official
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Title or Position | PRESIDENT/SECRETARY
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Name | DR. MICHAEL JOSEPH MALONEY
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Credential | D.D.S.
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Telephone | 518-782-9015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 043407
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License Number State | NY
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