Organization
MARQUIS CENTER OF CHARLESTON LLC
Active
Other names
Doctors Implants
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK A PETERSEN (DIRECTOR OF INFRASTRUCTURE)
(618) 402-6622
Entity
Organization
Contact information
Practice address
1470 TOBIAS GADSON BLVD STE 200, CHARLESTON, SC 29407-4925
(618) 402-6622
Mailing address
4447 N CENTRAL EXPY STE 110, DALLAS, TX 75205-4246
(618) 402-6622
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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