Individual
DR. CHARLOTTE COLLINS WIEDENMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
129 FAUBURG ST SW, AIKEN, SC 29801-3805
(803) 649-0430
Mailing address
129 FAUBURG ST SW, AIKEN, SC 29801-3805
(803) 649-0430
(803) 522-1878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
012182
GA
122300000X
Dentist
3844
SC
1223G0001X
General Practice Dentistry
Primary
3844
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17697
—
SC
05
—
ZX3844
—
SC
Enumeration date
05/25/2009
Last updated
12/28/2020
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