DR. Keith Stanley Wickizer, D.M.D., M.S., A.B.O.
NPI #1932198801 in Summerville, South Carolina
Provider Information
- NPI Number
- 1932198801
- Entity Type
- Individual
- Name
- DR. Keith Stanley Wickizer, D.M.D., M.S., A.B.O.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - Orthodontics and Dentofacial Orthopedics
- Credential
- D.M.D., M.S., A.B.O.
- Enumeration Date
- Oct 13, 2005
- Last Updated
- Apr 15, 2008
Practice Location
- Address
- 100 OMALLEY DR UNIT B
- City
- Summerville
- State
- South Carolina
- ZIP Code
- 29483-5635
- Phone
- (843) 261-0142
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
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