Wickizer, Keith Stanley

Wickizer, Keith Stanley is an individual health care provider with primary practice located at 100 Omalley Dr Unit B , Summerville SC 29483-5635. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Wickizer, Keith Stanley can be contacted via phone (843) 261-0142.

Contact Information

Primary practice address
100 Omalley Dr Unit B Summerville SC 29483-5635
Phone: (843) 261-0142
Fax: (843) 261-0125
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 4227 South Carolina
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 0657 South Carolina

Profile Details

NPI number 1932198801
LBN Legal business name Wickizer, Keith Stanley
Credentials D.M.D., M.S., A.B.O.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Apr 15th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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