MEDICARE: SARA VAUN MARSHALL RDH

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	124Q00000X	Dental Hygienist	DH074459	PA

General Provider Information

NPI Number	:	1225604929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA VAUN MARSHALL RDH

Provider Business Mailing Address
First Line	:	232 WAGNER ST
Second Line	:
City	:	LEHIGHTON
State	:	PA
Zip	:	18235-9281
Country	:	US
Telephone Number	:	484-629-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 S 3RD ST
Second Line	:
City	:	LEHIGHTON
State	:	PA
Zip	:	18235-2109
Country	:	US
Telephone Number	:	484-629-0002
Fax Number	:	610-377-5999

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

Provider Enumeration Date	:	06/02/2021
Last Update Date	:	06/02/2021

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Directions to “ SARA VAUN MARSHALL RDH” Practice Location

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