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General NPI Number Information
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NPI Number | 1881906477
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Entity Type | Individual
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Provider Name | MICHAEL REID MARSHALL D.M.D
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Gender | Male
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 2216 OLD SPRINGVILLE RD
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City | CENTER POINT
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State | AL
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Zip | 35215-4022
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Country | US
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Telephone | 205-853-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 GLADSTONE AVE
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City | BIRMINGHAM
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State | AL
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Zip | 35213-1423
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Country | US
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Telephone | 256-366-3827
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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 | 5758
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License Number State | AL
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