Provider Demographics
NPI:1457568008
Name:HANDSHUH, MARJORIE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:R
Last Name:HANDSHUH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 CLARK AVE #425
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712
Mailing Address - Country:US
Mailing Address - Phone:562-925-1003
Mailing Address - Fax:562-925-1007
Practice Address - Street 1:5220 CLARK AVE #425
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712
Practice Address - Country:US
Practice Address - Phone:562-925-1003
Practice Address - Fax:562-925-1007
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41835122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist