Individual
STUART D MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
150 S MAIN ST, STE 1, DRIGGS, ID 83455
(208) 354-9700
(208) 354-9701
Mailing address
150 S MAIN ST, STE 1, DRIGGS, ID 83422
(208) 354-9700
(208) 354-9701
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3890
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807204600
—
ID
Enumeration date
10/12/2006
Last updated
03/26/2018
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