Healthcare Provider Details

I. General information

NPI: 1942097407
Provider Name (Legal Business Name): MORGAN SIMONE MARSHALL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 W OAKRIDGE DR
ALBANY GA
31707-5307
US

IV. Provider business mailing address

1412 W OAKRIDGE DR
ALBANY GA
31707-5307
US

V. Phone/Fax

Practice location:
  • Phone: 229-435-2424
  • Fax:
Mailing address:
  • Phone: 229-435-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN124342
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: