Individual
JOAN S MALCOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
402 INDEPENDENCE BLVD, SICKLERVILLE, NJ 08081-1094
(856) 875-8775
(856) 875-8717
Mailing address
402 INDEPENDENCE BLVD, SICKLERVILLE, NJ 08081-1094
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI01975700
NJ
Other
Enumeration date
09/25/2009
Last updated
09/25/2009
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