Individual
JOSEPH MALLOUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
747 VICTORY HWY, SLATERSVILLE, RI 02876-0130
(401) 766-2805
(401) 765-2858
Mailing address
PO BOX 130, SLATERSVILLE, RI 02876-0130
(401) 766-2800
(401) 765-2858
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN02664
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8591-3
BLUE CROSS DENTAL RI
RI
01
—
RG 0130
BLUE CROSS MA DENTAL
MA
Enumeration date
08/19/2006
Last updated
07/08/2007
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