Individual
CALLI LAYNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8600 DORCHESTER RD STE 104, NORTH CHARLESTON, SC 29420-7382
(843) 473-6636
Mailing address
180 PATRIOTS POINT RD APT 503, MOUNT PLEASANT, SC 29464-5437
(570) 394-8245
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10733
SC
1223P0221X
Pediatric Dentistry
Primary
10733
SC
1223P0221X
Pediatric Dentistry
Primary
10937
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/17/2022
Last updated
08/08/2026
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