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NPI Code Detail

MEDICARE: SANDRA ANN MARSHALL DDS

MEDICARE: SANDRA ANN MARSHALL DDS
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
1390200000XStudent in an Organized Health Care Education/Training Program
2122300000XDentistDB-2023-0093NM

General Provider Information

NPI Number : 1144920349
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA ANN MARSHALL DDS
Provider Business Mailing Address
First Line : 7508 MCNERNEY AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-2224
Country : US
Telephone Number : 505-908-1981
Fax Number :
Provider Business Practice Location Address
First Line : 4201 CENTRAL AVE NW STE F1
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87105-1669
Country : US
Telephone Number : 505-843-7172
Fax Number : 505-352-6689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2023
Last Update Date : 05/26/2023

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Directions to “ SANDRA ANN MARSHALL DDS” Practice Location

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