Individual
DALLAS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
173 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 876-7645
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10487
SC
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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