Provider Demographics
NPI:1578600144
Name:MARSHALL, PAUL K II (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:K
Last Name:MARSHALL
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-0934
Mailing Address - Country:US
Mailing Address - Phone:507-775-0933
Mailing Address - Fax:508-775-0817
Practice Address - Street 1:306 WINTER ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-2960
Practice Address - Country:US
Practice Address - Phone:507-775-0933
Practice Address - Fax:508-775-0817
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA135791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice