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NPI Code Detail

MEDICARE: DR. WILLIAM MICHAEL MALONE D.D.S.

MEDICARE:  DR. WILLIAM MICHAEL MALONE  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2841LA

General Provider Information

NPI Number : 1174537260
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM MICHAEL MALONE D.D.S.
Provider Business Mailing Address
First Line : 300 DOUCET RD STE A
Second Line :
City : LAFAYETTE
State : LA
Zip : 70503-3400
Country : US
Telephone Number : 337-989-1268
Fax Number : 337-989-1324
Provider Business Practice Location Address
First Line : 300 DOUCET RD STE A
Second Line :
City : LAFAYETTE
State : LA
Zip : 70503-3400
Country : US
Telephone Number : 337-989-1268
Fax Number : 337-989-1324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/08/2007

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Directions to “ DR. WILLIAM MICHAEL MALONE D.D.S.” Practice Location

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