Jerry B Malleus, DDS Inc.

NPI #1922498302 in San Fernando, California

Provider Information

NPI Number: 1922498302
Entity Type: Organization
Organization Name: Jerry B Malleus, DDS Inc.
Primary Specialty: Dentist
Enumeration Date: Jan 23, 2015
Last Updated: Jan 23, 2015

Practice Location

Address: 125 S BRAND BLVD
City: San Fernando
State: California
ZIP Code: 91340-3304
Phone: (818) 365-6321

Authorized Official

Name: DR. JERRY B MALLEUS, DDS
Title: PRES.
Phone: (818) 832-5102

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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