Individual
CANDACE KIERA MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5040 E INTERSTATE 30 STE 100, FATE, TX 75189-8545
(469) 745-0221
Mailing address
PO BOX 2909, FORNEY, TX 75126-2909
(318) 614-0047
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
38037
TX
1223G0001X
General Practice Dentistry
7042
LA
Other
Enumeration date
12/17/2018
Last updated
06/03/2024
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