Provider Demographics
NPI:1659500189
Name:DR. MARCUS E. TROMBLEY, DDS-LLC
Entity Type:Organization
Organization Name:DR. MARCUS E. TROMBLEY, DDS-LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:E
Authorized Official - Last Name:TROMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:803-324-7567
Mailing Address - Street 1:2811 ARROWWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8444
Mailing Address - Country:US
Mailing Address - Phone:803-329-2667
Mailing Address - Fax:803-329-1134
Practice Address - Street 1:1144 INDIA HOOK RD.
Practice Address - Street 2:SUITE A
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2400
Practice Address - Country:US
Practice Address - Phone:803-324-7567
Practice Address - Fax:803-324-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ16625Medicaid