Provider Demographics
NPI:1871705640
Name:GEORGE E. MALONEY, D.M.D.
Entity type:Organization
Organization Name:GEORGE E. MALONEY, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-752-1007
Mailing Address - Street 1:334 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-2131
Mailing Address - Country:US
Mailing Address - Phone:508-752-1007
Mailing Address - Fax:
Practice Address - Street 1:334 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-2131
Practice Address - Country:US
Practice Address - Phone:508-752-1007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14984122300000X
MA216236171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851403083OtherNPI TYPE 1
MA0259144Medicaid