Healthcare Provider Details

I. General information

NPI: 1366589400
Provider Name (Legal Business Name): JULIE ANN MARSHALL D.D.S.,M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 S 48TH ST
LINCOLN NE
68506-3391
US

IV. Provider business mailing address

2810 S 48TH ST
LINCOLN NE
68506-3391
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-4171
  • Fax:
Mailing address:
  • Phone: 402-483-4171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number5500
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: