Provider Demographics
NPI:1780977165
Name:CHAPMAN, MARSHALL ALEXANDER (DMD)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:ALEXANDER
Last Name:CHAPMAN
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 1:1007 GROVE ROAD SUITE D
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:24605
Mailing Address - Country:US
Mailing Address - Phone:770-486-5585
Mailing Address - Fax:770-486-9877
Practice Address - Street 1:1007 GROVE ROAD SUITE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605
Practice Address - Country:US
Practice Address - Phone:864-509-6435
Practice Address - Fax:770-486-9877
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014183122300000X
SC6956122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist