Individual
DUANE GLENN MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4405 JAGER DR NE STE C1, RIO RANCHO, NM 87144-5715
(505) 692-8167
Mailing address
2050A SECOND ST SE, 377 MDG, KIRTLAND AFB, NM 87117-5522
(505) 846-3027
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD3353
NM
1223G0001X
General Practice Dentistry
DD3353
NM
Other
Enumeration date
08/05/2010
Last updated
11/03/2023
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