Provider Demographics
NPI:1669893335
Name:WARREN S MARSHALL DDS
Entity type:Organization
Organization Name:WARREN S MARSHALL DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-537-6726
Mailing Address - Street 1:3425 EXECUTIVE PKWY
Mailing Address - Street 2:SUITE 214
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1326
Mailing Address - Country:US
Mailing Address - Phone:419-537-6726
Mailing Address - Fax:419-537-6746
Practice Address - Street 1:3425 EXECUTIVE PKWY
Practice Address - Street 2:SUITE 214
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1326
Practice Address - Country:US
Practice Address - Phone:419-537-6726
Practice Address - Fax:419-537-6746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16346122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty