Individual
NIKLAS MALMSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6481 OLD BEULAH ST, ALEXANDRIA, VA 22315-3723
(703) 997-6073
Mailing address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-3000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418079
VA
Other
Enumeration date
04/22/2020
Last updated
10/20/2022
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