Provider Demographics
NPI:1992259212
Name:DON G MARSHALL, DDS
Entity type:Organization
Organization Name:DON G MARSHALL, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-327-3368
Mailing Address - Street 1:707 W FRANCIS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6401
Mailing Address - Country:US
Mailing Address - Phone:509-327-3368
Mailing Address - Fax:509-325-2712
Practice Address - Street 1:707 W FRANCIS AVE STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6401
Practice Address - Country:US
Practice Address - Phone:509-327-3368
Practice Address - Fax:509-325-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 00007116122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1699770537Medicaid
1699770537Medicare PIN