Provider Demographics
NPI:1629675574
Name:MARSH, SHEILA M (RDH)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:MARSH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ASHTON DR
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-9706
Mailing Address - Country:US
Mailing Address - Phone:518-569-2518
Mailing Address - Fax:
Practice Address - Street 1:37 BOYNTON AVE STE 2
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1268
Practice Address - Country:US
Practice Address - Phone:518-563-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022927124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist