Provider Demographics
NPI:1255456729
Name:LANGOHR, MARSHALL EDWARD SR (DDS)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:EDWARD
Last Name:LANGOHR
Suffix:SR
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 1:509 OLIVE WAY
Mailing Address - Street 2:SUITE 1221
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1720
Mailing Address - Country:US
Mailing Address - Phone:206-623-6263
Mailing Address - Fax:206-667-9143
Practice Address - Street 1:509 OLIVE WAY
Practice Address - Street 2:SUITE 1221
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1720
Practice Address - Country:US
Practice Address - Phone:206-623-6263
Practice Address - Fax:206-667-9143
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000048751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice