Organization
MALCOLM PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDY JOE MALCOLM DDS (PEDIATRIC DENTIST)
(815) 544-0909
Entity
Organization
Contact information
Practice address
163 CADILLAC CT, SUITE 3, BELVIDERE, IL 61008-1737
(815) 544-0909
(815) 544-0922
Mailing address
163 CADILLAC CT, SUITE 3, BELVIDERE, IL 61008-1737
(815) 544-0909
(815) 544-0922
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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