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General NPI Number Information
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NPI Number | 1942451240
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Entity Type | Individual
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Provider Name | TIMOTHY DEAN MARSHALL D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2008
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 420 E 3RD ST
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City | FARMVILLE
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State | VA
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Zip | 23901-1512
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Country | US
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Telephone | 434-395-1228
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Fax | 434-395-1232
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Provider Business Mailing Address
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Address Line | 420 E 3RD ST
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City | FARMVILLE
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State | VA
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Zip | 23901-1512
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Country | US
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Telephone | 434-395-1228
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Fax | 434-395-1232
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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 | 0401412220
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License Number State | VA
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