Leo J. Malin, D.d.s., S.c.

NPI #1861643017 in Sparta, Wisconsin

Provider Information

NPI Number: 1861643017
Entity Type: Organization
Organization Name: Leo J. Malin, D.d.s., S.c.
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Oct 7, 2008
Last Updated: Oct 7, 2008

Practice Location

Address: 3000 RILEY RD
Address 2: SUITE A
City: Sparta
State: Wisconsin
ZIP Code: 54656-6588
Phone: (608) 269-0607

Authorized Official

Name: DR. LEO J. MALIN, DDS
Title: OWNER
Phone: (608) 269-0607

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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