Individual
DR. JOHN MARSHALL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2315 TECHNOLOGY DR STE 101, O FALLON, MO 63368-7371
(636) 561-9255
(636) 625-9028
Mailing address
2315 TECHNOLOGY DR STE 101, O FALLON, MO 63368-7371
(636) 561-9255
(636) 625-9028
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2018011363
MO
1223G0001X
General Practice Dentistry
2018011363
MO
Other
Enumeration date
06/20/2017
Last updated
09/22/2018
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