Organization
H RICHARD MARSHALL JR DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE M GRAGG (OFFICE MANAGER)
(304) 645-3110
Entity
Organization
Contact information
Practice address
120 MAPLEWOOD AVE, RONCEVERTE, WV 24970
(304) 645-3110
(301) 645-3209
Mailing address
120 MAPLEWOOD AVE, RONCEVERTE, WV 24970
(304) 645-3110
(301) 645-3209
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
WV1914
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135577000
—
WV
Enumeration date
10/12/2006
Last updated
08/22/2020
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