Provider Demographics
NPI:1871770370
Name:MALFARA, ROBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:MALFARA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 S BREWSTER RD
Mailing Address - Street 2:SUITE A2
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-7801
Mailing Address - Country:US
Mailing Address - Phone:856-692-0060
Mailing Address - Fax:856-692-0382
Practice Address - Street 1:630 S BREWSTER RD
Practice Address - Street 2:SUITE A2
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-7801
Practice Address - Country:US
Practice Address - Phone:856-692-0060
Practice Address - Fax:856-692-0382
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI17162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist