Wietecha, Scott C

Wietecha, Scott C is an individual health care provider with primary practice located at 7033 Saint Andrews Rd Suite 102, Columbia SC 29212-1179. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Wietecha, Scott C can be contacted via phone (803) 781-3321.

Contact Information

Primary practice address
7033 Saint Andrews Rd Suite 102 Columbia SC 29212-1179
Phone: (803) 781-3321
Fax: (803) 781-4406
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 2148 South Carolina

Profile Details

NPI number 1114092707
LBN Legal business name Wietecha, Scott C
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2006
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1114092707 NPPES
South Carolina Other 2148 DENTAL LICENSE
South Carolina MEDICAID ZZ2148 DENTAL LICENSE

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