Marquis Center of Charleston LLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

MARQUIS CENTER OF CHARLESTON LLC

Doing business as

Doctors Implants

Practice address

1470 Tobias Gadson Blvd Ste 200
Charleston, SC 29407-4925

Phone

(618) 402-6622

NPI assigned

Jun 30, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clark A Petersen

Title

Director of Infrastructure

Phone

(618) 402-6622

Specialties & licenses 1

Addresses

Other names 1

• Doctors Implants Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1174412787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4447 N CENTRAL EXPY STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752054246",
            "telephone_number": "618-402-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 TOBIAS GADSON BLVD STE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074925",
            "telephone_number": "618-402-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARQUIS CENTER OF CHARLESTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF INFRASTRUCTURE",
        "authorized_official_telephone_number": "618-402-6622"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor Marlow
• Troy J Marlow, MD
• Ross Marnock, DO
• Gillian Maro, LISW-CP
• Michael Stephen Marotta, M.D.
• Mallory Marra
• Sarah Tucker Marrison, MD/PHD
• Cayla H Marscher, FNP-C
• Leanee Amber Marsh
• Marshall N. Kalinsky, D.P.M.

• Oral and Maxillofacial Surgery Clinic/Center in Charleston, SC
• Providers in Charleston, SC by specialty
• Oral and Maxillofacial Surgery Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.