Organization
M M ORTHODONTICS PA
Active
Other names
M & M Orthodontics, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA T MALONE D.D.S.,M.S. (ORTHODONTIST)
(210) 667-2929
Entity
Organization
Contact information
Practice address
6735 FM 78, SUITE 102, SAN ANTONIO, TX 78244-1367
(210) 667-2929
(210) 661-2575
Mailing address
6735 FM 78, SUITE 102, SAN ANTONIO, TX 78244-1367
(210) 667-2929
(210) 661-2575
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
20402
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
21086
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
23783
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1312131
UNITED CONCORDIA
TX
05
—
142539904
—
TX
05
—
142539905
—
TX
05
—
142539907
—
TX
05
—
174951702
—
TX
05
—
174952502
—
TX
Enumeration date
08/09/2006
Last updated
08/12/2008
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