MEDICARE: DR. JOHN WALKER MARSH DDS

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
1	1223G0001X	General Practice Dentistry	37582	CA

General Provider Information

NPI Number	:	1962475863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN WALKER MARSH DDS

Provider Business Mailing Address
First Line	:	5565 CARPINTERIA AVE STE 2
Second Line	:
City	:	CARPINTERIA
State	:	CA
Zip	:	93013-1446
Country	:	US
Telephone Number	:	805-684-4537
Fax Number	:

Provider Business Practice Location Address
First Line	:	5565 CARPINTERIA AVE STE 2
Second Line	:
City	:	CARPINTERIA
State	:	CA
Zip	:	93013-1446
Country	:	US
Telephone Number	:	805-684-4537
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	12/15/2008

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