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Organization
TERRY L. MALCOLM, DDS, PC
Active
Organization
TERRY L. MALCOLM, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY MALCOLM DDS (OWNER/PRESIDENT)
(402) 245-4636
Entity
Organization
Contact information
Practice address
1910 CHASE ST, FALLS CITY, NE 68355-2021
(402) 245-4636
(402) 245-3325
Mailing address
PO BOX 188, 1910 CHASE STREET, FALLS CITY, NE 68355-0188
(402) 245-4636
(402) 245-3325
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5779
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025280600
—
NE
Enumeration date
08/18/2006
Last updated
06/29/2015
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