Individual
DR. JERRY LEE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
135A-B RADIO CITY DRIVE, NORTH PEKIN, IL 61554
(309) 382-2229
(309) 382-1155
Mailing address
466 S PRAIRIE ST, BETHALTO, IL 62010-1816
(618) 377-2482
(618) 377-5228
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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