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General NPI Number Information
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NPI Number | 1922272467
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Entity Type | Organization
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Legal Business Name | MAX A MALKOFF DMD
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 3040 BELMONT AVE SUITE B
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-1836
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Country | US
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Telephone | 330-759-7007
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Fax | 330-759-2959
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Provider Business Mailing Address
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Address Line | 3040 BELMONT AVE SUITE B
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-1836
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Country | US
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Telephone | 330-759-7007
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Fax | 330-759-2959
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MAX A MALKOFF
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Credential | DMD
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Telephone | 330-759-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.012912
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License Number State | OH
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