Provider Demographics
NPI:1811087679
Name:MARSHALL, WARREN S (DDS)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:S
Last Name:MARSHALL
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 1:3425 EXECUTIVE PARKWAY
Mailing Address - Street 2:SUITE 214
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1134
Mailing Address - Country:US
Mailing Address - Phone:419-537-6726
Mailing Address - Fax:419-537-6746
Practice Address - Street 1:3425 EXECUTIVE PARKWAY
Practice Address - Street 2:SUITE 214
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1134
Practice Address - Country:US
Practice Address - Phone:419-537-6726
Practice Address - Fax:419-537-6746
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16346122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist