Provider Demographics
NPI:1629272679
Name:MAMALIGER, IOSEF (DDS)
Entity type:Individual
Prefix:MR
First Name:IOSEF
Middle Name:
Last Name:MAMALIGER
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 1:544 WEST DRUMMOND AVENUE
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555
Mailing Address - Country:US
Mailing Address - Phone:760-446-7343
Mailing Address - Fax:760-446-7359
Practice Address - Street 1:544 WEST DRUMMOND AVENUE
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555
Practice Address - Country:US
Practice Address - Phone:760-446-7343
Practice Address - Fax:760-446-7359
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40270122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist