Individual
DR. MARK MALINOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-0345
Mailing address
430 MAIN ST, GREEN BAY, WI 54301-5115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6791-15
WI
1223G0001X
General Practice Dentistry
6791-015
WI
1223G0001X
General Practice Dentistry
Primary
6791-15
WI
Other
Enumeration date
09/02/2011
Last updated
10/23/2020
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