Provider Demographics
NPI:1215947437
Name:MUSHLIN, MARSHA LYNN (DDS)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:LYNN
Last Name:MUSHLIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:LYNN
Other - Last Name:LEVENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 FARINA ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2833
Mailing Address - Country:US
Mailing Address - Phone:617-965-5164
Mailing Address - Fax:
Practice Address - Street 1:19 FARING ROAD
Practice Address - Street 2:
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-2833
Practice Address - Country:US
Practice Address - Phone:617-630-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice