Individual
DR. MARK LANE MCENTIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
173 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-2880
Mailing address
1025 RIVERLAND WOODS PL APT 906, CHARLESTON, SC 29412-4141
(803) 924-3857
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
4488
SC
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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