| Organization Name: | TERRY L. MALCOLM, DDS, PC |
| NPI Number: | 1962516781 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRY MALCOLM (OWNER/PRESIDENT) |
| Mailing Address: | 1910 Chase St Falls City |
| State: | NE US |
| Postal Code: | 683552021 |
| Phone Number: | 4022454636 |
| Fax Number: | 4022453325 |
| NPI Enumeration Date: | 08/18/2006 |
| NPI Last Update Date: | 06/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 5779 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |