MEDICARE: ROBERT JAY MARSHALL DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	2384	MT
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	2384	MT

General Provider Information

NPI Number	:	1063670032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JAY MARSHALL DDS, MS

Provider Business Mailing Address
First Line	:	2525 6TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-3013
Country	:	US
Telephone Number	:	406-761-0314
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 6TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-3013
Country	:	US
Telephone Number	:	406-761-0314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	02/19/2025

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