# MALCOLM C. GEORGE, DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568719151
- **Authorized official:** MALCOLM C. GEORGE DDS (DENTIST)
- **Authorized official phone:** (260) 726-4710

## Contact information

- **Practice address:** 112 N SHIP ST, PORTLAND, IN 47371-1844
- **Practice address phone:** (260) 726-4710
- **Practice address fax:** (260) 726-7051
- **Mailing address:** 112 N SHIP ST, PORTLAND, IN 47371-1844
- **Mailing address phone:** (260) 726-4710
- **Mailing address fax:** (260) 726-7051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12010495 | IN | Yes |

## Other

- **Enumeration date:** 08/14/2012
- **Last updated:** 08/14/2012