Provider Demographics
NPI:1528502218
Name:MALEK & KNIGHT DDS PA VI
Entity type:Organization
Organization Name:MALEK & KNIGHT DDS PA VI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:METOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-481-2220
Mailing Address - Street 1:303 S WALTON DR
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-9396
Mailing Address - Country:US
Mailing Address - Phone:919-894-1612
Mailing Address - Fax:
Practice Address - Street 1:303 S WALTON DR
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-9396
Practice Address - Country:US
Practice Address - Phone:919-894-1612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MALEK & KNIGHT DDS PA I
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7146122300000X
122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty