Provider Demographics
NPI:1831825462
Name:MARRS, MARSHALL L (DMD)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:L
Last Name:MARRS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20204 G RD
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:KS
Mailing Address - Zip Code:67844-9116
Mailing Address - Country:US
Mailing Address - Phone:620-635-5475
Mailing Address - Fax:
Practice Address - Street 1:120 S FOWLER ST
Practice Address - Street 2:
Practice Address - City:MEADE
Practice Address - State:KS
Practice Address - Zip Code:67864-6404
Practice Address - Country:US
Practice Address - Phone:620-873-2802
Practice Address - Fax:620-873-5308
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS619511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice