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Marquis Center of Charleston LLC — NPI 1174412787, Charleston, SC | NPI Central

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NPI 1174412787

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Marquis Center of Charleston LLC

NPI 1174412787 · Oral and Maxillofacial Surgery Clinic/Center · Charleston, SC

Provider details

NPI number: 1174412787
Entity type: Organization
Primary specialty: Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
Organization subpart: No
Authorized official: Clark Petersen, Director of Infrastructure(618) 402-6622

Specialties & taxonomies

Oral and Maxillofacial Surgery Clinic/CenterPrimary261QS0112X
Ambulatory Health Care Facilities

Practice location

1470 Tobias Gadson Blvd Ste 200

Charleston, SC 29407-4925

Phone: (618) 402-6622

Approximate (ZIP-level) locationGet directions

More SC providers

Mailing address

4447 N Central Expy Ste 110

Dallas, TX 75205-4246

Other names (DBA / former)

Doing business as: Doctors Implants

Registry dates

Enumerated: 2025-06-30
Last updated: 2025-06-30
Certified: 2025-06-30

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.