DR. Mark Anthony Chishom, DMD

NPI #1417908328 in Elgin, South Carolina

Provider Information

NPI Number: 1417908328
Entity Type: Individual
Name: DR. Mark Anthony Chishom, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Oral & Maxillofacial Surgery
Credential: DMD
Enumeration Date: May 15, 2006
Last Updated: Apr 2, 2015

Practice Location

Address: 102 BUCKTHORN CIR
City: Elgin
State: South Carolina
ZIP Code: 29045-8695
Phone: (803) 477-4909

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Oral & Maxillofacial Surgery	204E00000X	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X

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