Individual
HANS MALMSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
625 ELMWOOD AVE, BOX 683, ROCHESTER, NY 14620-2913
(585) 275-5087
(585) 276-0293
Mailing address
625 ELMWOOD AVE, BOX 683, ROCHESTER, NY 14620-2913
(585) 275-5087
(585) 276-0293
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
044097
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7165
BLUE SHIELD GROUP NUMBER
—
Enumeration date
08/25/2006
Last updated
03/08/2016
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