| NPI | 1568784569 |
|---|---|
| Doing Business As | DR JERRY B MALLEUS |
| Entity Type | Organization |
| Authorized Contact | LARRY E FERGUSON Business Manager 818-365-6321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 24826) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |