Provider Demographics
NPI:1083507016
Name:MALSON, MALSON (DMD)
Entity type:Individual
Prefix:
First Name:MALSON
Middle Name:
Last Name:MALSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3310
Mailing Address - Country:US
Mailing Address - Phone:214-552-7562
Mailing Address - Fax:
Practice Address - Street 1:4901 W BELL RD STE 100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3414
Practice Address - Country:US
Practice Address - Phone:602-843-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD012510122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist