Individual
KEVIN J WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2860 WESTINGHOUSE RD, HORSEHEADS, NY 14845
(607) 796-2663
(607) 796-0064
Mailing address
2511 CORNING RD, ELMIRA, NY 14903-1047
(607) 796-5985
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
041448
NY
Other
Enumeration date
08/29/2006
Last updated
04/06/2016
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