Organization
1ST DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDUL G MALAKI DDS (DENTIST)
(630) 859-9340
Entity
Organization
Contact information
Practice address
1556 DOUGLAS RD, MONTGOMERY, IL 60538-1645
(630) 859-9340
(630) 859-9341
Mailing address
1556 DOUGLAS RD, MONTGOMERY, IL 60538-1645
(630) 859-9340
(630) 859-9341
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019023856
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114091030
—
IL
Enumeration date
11/22/2006
Last updated
10/20/2014
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