Provider Demographics
NPI:1396946893
Name:MARSHALL, RICHARD EARL II (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:EARL
Last Name:MARSHALL
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2027 PULASKI HWY STE 113
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-2146
Mailing Address - Country:US
Mailing Address - Phone:410-939-2171
Mailing Address - Fax:443-502-5168
Practice Address - Street 1:2027 PULASKI HWY STE 113
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-2146
Practice Address - Country:US
Practice Address - Phone:410-939-2171
Practice Address - Fax:144-350-2516
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD076921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics