Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 01152 | NH |
NPI | 1003202490 |
---|---|
Provider Name | Linda Carol Marshall |
First Address | Concord, NH 03304 |
Second Address | Concord, NH 03304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 13/04/2015 |