Provider Demographics
NPI:1205051034
Name:MARSHALL, RAYMOND COLLINS (DDS)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:COLLINS
Last Name:MARSHALL
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 1:13504 MONTVALE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1234
Mailing Address - Country:US
Mailing Address - Phone:301-731-4522
Mailing Address - Fax:301-731-5871
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:SUITE 304
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:301-731-4522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD65901223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics