Individual
CALLI LAYNE BARANOUSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
808 WAPPOO RD, CHARLESTON, SC 29407-5865
(843) 212-8820
Mailing address
180 PATRIOTS POINT RD # 503, MOUNT PLEASANT, SC 29464-4377
(570) 394-8245
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10733
SC
1223P0221X
Pediatric Dentistry
Primary
10733
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/17/2022
Last updated
08/11/2024
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