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General NPI Number Information
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NPI Number | 1679564363
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Entity Type | Individual
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Provider Name | ERIC SETH MARSHALL DMD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 21 NORTH MAIN ST SUITE 202
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City | PORT CHESTER
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State | NY
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Zip | 10573
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Country | US
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Telephone | 914-939-3278
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Fax | 914-939-3279
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Provider Business Mailing Address
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Address Line | 21 NORTH MAIN ST SUITE 202
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City | PORT CHESTER
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State | NY
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Zip | 10573
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Country | US
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Telephone | 914-939-3278
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Fax | 914-939-3279
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 038682
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License Number State | NY
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