Provider Demographics
NPI:1164036893
Name:JOHN P. MARSHALL DDS,PC
Entity Type:Organization
Organization Name:JOHN P. MARSHALL DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-291-3302
Mailing Address - Street 1:PO BOX 408
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:MI
Mailing Address - Zip Code:48884-0408
Mailing Address - Country:US
Mailing Address - Phone:989-291-3302
Mailing Address - Fax:989-291-3078
Practice Address - Street 1:215 S CENTER ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:MI
Practice Address - Zip Code:48884-9301
Practice Address - Country:US
Practice Address - Phone:989-291-3302
Practice Address - Fax:989-291-3078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty