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Individual
SARAH E WICHETA
Active
Individual
SARAH E WICHETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN1859322
MA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
1024186
MA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DL14025
MA
Other
Enumeration date
06/11/2019
Last updated
06/09/2026
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