Individual
DR. JACOB W MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5337 W GRANDE MARKET DR, APPLETON, WI 54913-8442
(920) 731-7445
Mailing address
5337 W GRANDE MARKET DR, APPLETON, WI 54913-8442
(920) 731-7445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002093
WI
Other
Enumeration date
06/05/2019
Last updated
06/25/2024
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