Individual
DR. ABDULAZIZ MALLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
240 S 40TH ST, PHILADELPHIA, PA 19104-6030
(804) 393-8782
Mailing address
520 N 12TH ST, RICHMOND, VA 23298-5064
(804) 393-8782
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417346
VA
1223E0200X
Endodontics
DS044851
PA
Other
Enumeration date
05/18/2021
Last updated
12/10/2024
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