Provider Demographics
NPI:1457401853
Name:BATCHELOR, MARSHALL LEWIS (DDS)
Entity Type:Individual
Prefix:
First Name:MARSHALL
Middle Name:LEWIS
Last Name:BATCHELOR
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 1:4004 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-6203
Mailing Address - Country:US
Mailing Address - Phone:425-258-4461
Mailing Address - Fax:
Practice Address - Street 1:4004 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-6203
Practice Address - Country:US
Practice Address - Phone:425-258-4461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA48271223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics