Individual
DR. MARK LANGLEY MCINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
201 FRONTAGE RD, STE 1, CLEMSON, SC 29631
(864) 654-7534
(864) 654-4830
Mailing address
201 FRONTAGE RD, STE 1, CLEMSON, SC 29631
(864) 654-7534
(864) 654-4830
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3514
SC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0504
SC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
3514 SPEC 0504
SC
Other
Enumeration date
05/03/2006
Last updated
01/11/2018
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