Provider Demographics
NPI:1891827614
Name:STAMEY, MARK CURTIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CURTIS
Last Name:STAMEY
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:PO BOX 734
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670
Mailing Address - Country:US
Mailing Address - Phone:864-646-7532
Mailing Address - Fax:
Practice Address - Street 1:216 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:SC
Practice Address - Zip Code:29670
Practice Address - Country:US
Practice Address - Phone:864-646-7532
Practice Address - Fax:864-646-7392
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ2762Medicaid