Individual
DR. ANDY J MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
163 CADILLAC CT, SUITE 3, BELVIDERE, IL 61008-1737
(815) 544-0909
(815) 544-0922
Mailing address
163 CADILLAC CT, SUITE 3, BELVIDERE, IL 61008-1737
(815) 544-0909
(815) 544-0922
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
IL
Other
Enumeration date
10/11/2006
Last updated
07/27/2007
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