Organization
ACUITY DENTISTRY AND ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH STANLEY WICKIZER DMD MS (OWNER)
(843) 261-2001
Entity
Organization
Contact information
Practice address
953 ORANGEBURG RD STE A, SUMMERVILLE, SC 29483-8941
(843) 261-2001
Mailing address
953 ORANGEBURG RD STE A, SUMMERVILLE, SC 29483-8941
(843) 261-2001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4227
SC
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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