Provider Demographics
NPI:1700033248
Name:ESPINAL, MARK A (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:ESPINAL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2391 DAVE LYLE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7939
Mailing Address - Country:US
Mailing Address - Phone:803-325-9000
Mailing Address - Fax:
Practice Address - Street 1:2391 DAVE LYLE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7939
Practice Address - Country:US
Practice Address - Phone:803-325-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4520122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist