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General NPI Number Information
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NPI Number | 1871641092
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Entity Type | Individual
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Provider Name | DAVID MARTIN MARSHAK DDS
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/03/2012
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Provider Practice Location Address
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Address Line | 200 S EL MOLINO AVE #5
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City | PASADENA
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State | CA
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Zip | 91101-2985
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Country | US
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Telephone | 626-796-5496
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Fax | 626-793-8961
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Provider Business Mailing Address
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Address Line | 200 S EL MOLINO AVE #5
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City | PASADENA
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State | CA
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Zip | 91101-2985
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Country | US
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Telephone | 626-796-5496
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Fax | 626-793-8961
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 20559
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License Number State | CA
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