Individual
DR. BRANDON SCOTT WISHNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1971 N MAIN ST, SUMMERVILLE, SC 29486-7820
(843) 871-0842
Mailing address
515 AMALIE FARMS DR, CHARLESTON, SC 29492-8591
(240) 491-2160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9210
SC
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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