Individual
DR. MARK GRIFFITH LARUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2011-A BEES FERRY ROAD, CHARLESTON, SC 29414
(843) 852-0780
(843) 852-0788
Mailing address
2011-A BEES FERRY ROAD, CHARLESTON, SC 29414
(843) 852-0780
(843) 852-0788
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3225
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232251
—
SC
05
—
Z32251
—
SC
Enumeration date
09/29/2006
Last updated
07/08/2007
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