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Individual

DR. GREGORY B. WIGGINS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD, PA

Contact information

Practice address
2170 ASHLEY PHOSPHATE RD, SUITE 600, NORTH CHARLESTON, SC 29406-4190
(843) 569-1717
(843) 569-6139
Mailing address
2170 ASHLEY PHOSPHATE RD, SUITE 600, NORTH CHARLESTON, SC 29406-4190
(843) 569-1717
(843) 569-6139

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0513
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZX3375
SC
Enumeration date
04/26/2006
Last updated
07/09/2007
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