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NPI Code Detail

MEDICARE: AMANDA KRISTEN MARSHALL DMD

MEDICARE: AMANDA KRISTEN MARSHALL DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12985TN
2122300000XDentistD012536AZ

General Provider Information

NPI Number : 1861380511
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA KRISTEN MARSHALL DMD
Provider Business Mailing Address
First Line : 1923 SULPHUR SPRINGS RD
Second Line :
City : MORRISTOWN
State : TN
Zip : 37813-5654
Country : US
Telephone Number : 423-317-9344
Fax Number : 423-714-2355
Provider Business Practice Location Address
First Line : 5500 CREEKWOOD PARK BLVD
Second Line :
City : LENOIR CITY
State : TN
Zip : 37772-1200
Country : US
Telephone Number : 865-986-8082
Fax Number : 865-986-5890
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2025
Last Update Date : 11/06/2025

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Directions to “ AMANDA KRISTEN MARSHALL DMD” Practice Location

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