Individual
SCOTT CHRISTOPHER MALTHANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTIST DMD
Contact information
Practice address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-5123
Mailing address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-5123
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS029123L
PA
1223P0300X
Periodontics
Primary
DS029123L
PA
Other
Enumeration date
02/10/2006
Last updated
08/10/2021
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