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Organization
TRIDENT DENTAL SPECIALTY PARTNERS
Active
Organization
TRIDENT DENTAL SPECIALTY PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK YAMPOLSKY DDS (PARTNER)
(843) 552-2580
Entity
Organization
Contact information
Practice address
6335 DORCHESTER RD, CHARLESTON, SC 29418-5103
(843) 552-2580
Mailing address
6335 DORCHESTER RD, CHARLESTON, SC 29418-5103
(843) 552-2580
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2962
SC
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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