Provider Demographics
NPI:1780769091
Name:DONOHUE, MARLA DANSBY (DDS)
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:DANSBY
Last Name:DONOHUE
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 1:2117 CENTRAL DR
Mailing Address - Street 2:#100
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021
Mailing Address - Country:US
Mailing Address - Phone:817-267-3449
Mailing Address - Fax:817-267-5669
Practice Address - Street 1:2117 CENTRAL DR
Practice Address - Street 2:#100
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021
Practice Address - Country:US
Practice Address - Phone:817-267-3449
Practice Address - Fax:817-267-5669
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16492122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist