Dr Jerry B Malleus

LBN: San Fernando Dental Center
Dr Jerry B Malleus is an health care organization with primary practice located at 125 S Brand Blvd , San Fernando CA 91340-3304. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. San Fernando Dental Center can be contacted via phone (818) 365-6321, or through Ferguson, Larry E via phone (818) 365-6321.

Contact Information

Primary practice address
125 S Brand Blvd San Fernando CA 91340-3304
Phone: (818) 365-6321
Fax: (818) 365-0011
Website:
Map and Directions
Authorized official contact:
Name: Ferguson, Larry E
Phone: (818) 365-6321

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 24826 California

Profile Details

NPI number 1568784569
LBN Legal business name San Fernando Dental Center
DBA Doing business as Dr Jerry B Malleus
Authorized official Ferguson, Larry E
Entity Organization
Organization subpart 1 No
Enumeration date Feb 18th, 2010
Last updated Feb 18th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568784569 NPPES
California Other 24826 CALIFORNIA BOARD OF DENTAL EXAMINERS

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