Provider Demographics
NPI:1568079424
Name:MALAGA, ALVARO (DDS)
Entity type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:
Last Name:MALAGA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4316 BENNINGTON CREEK LN
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125-9087
Mailing Address - Country:US
Mailing Address - Phone:906-364-5364
Mailing Address - Fax:
Practice Address - Street 1:131 W WHEELING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3708
Practice Address - Country:US
Practice Address - Phone:740-654-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0269491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics