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General NPI Number Information
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NPI Number | 1154597169
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Entity Type | Individual
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Provider Name | TREVOR SCOTT MARSHALL DDS
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Gender | Male
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 300 E MADISON ST
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City | BALTIMORE
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State | MD
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Zip | 21202-4260
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Country | US
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Telephone | 410-209-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 1 NEW FOREST CT
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City | TOWSON
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State | MD
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Zip | 21286-1741
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Country | US
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Telephone | 410-296-2051
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13819
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License Number State | MD
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