Individual
MALCOLM D STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
159-08 HILLSIDE AVE, JAMAICA, NY 11432
(718) 523-3631
(718) 523-3631
Mailing address
292 SCHENCK AVE, BROOKLYN, NY 11207
(347) 715-3182
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
043611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01265796
—
NY
01
—
043611
LIC NUMBER
NY
Enumeration date
05/02/2007
Last updated
07/08/2007
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