Provider Demographics
NPI:1366411175
Name:FESCHE, MARSHALL WESLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:WESLEY
Last Name:FESCHE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 MUSGROVE RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-1635
Mailing Address - Country:US
Mailing Address - Phone:410-252-1445
Mailing Address - Fax:
Practice Address - Street 1:603 NURSERY RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6109
Practice Address - Country:US
Practice Address - Phone:410-876-6612
Practice Address - Fax:410-876-3760
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD53821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice