Organization
DEEPLI MALLA DDS
Active
Other names
Deepli Malla DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPLI MALLA DDS (SELF)
(559) 909-4354
Entity
Organization
Contact information
Practice address
2059 HIGH ST, SELMA, CA 93662-3512
(559) 896-8888
Mailing address
2059 HIGH ST, SELMA, CA 93662-3512
(559) 909-4354
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114536570
—
CA
Enumeration date
11/11/2020
Last updated
11/11/2020
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