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Individual

LYNNE LESLIE MARSHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1 TROWBRIDGE RD, BOURNE, MA 02532
(508) 759-7200
(508) 759-7219
Mailing address
1 TROWBRIDGE RD, BOURNE, MA 02532-3660
(508) 759-7200
(508) 759-7219

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15197
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
X11722
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/02/2006
Last updated
01/17/2008
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