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General NPI Number Information
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NPI Number | 1992525372
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Entity Type | Organization
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Legal Business Name | MARSTON-SMITH PS DDS INC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 490 S FARRELL DR STE C101
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City | PALM SPRINGS
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State | CA
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Zip | 92262-7962
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Country | US
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Telephone | 760-320-7621
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Fax |
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Provider Business Mailing Address
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Address Line | 14310 EDEN GRV
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City | POWAY
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State | CA
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Zip | 92064-2367
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ORTHODONTIST
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Name | BLAKE MARSTON
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Credential | DDS
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Telephone | 480-239-8720
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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