Individual
DR. PATTY R VAN WIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1247 HIGHWAY 17, LITTLE RIVER, SC 29566-9211
(843) 249-4092
(843) 249-1638
Mailing address
PO BOX 635, LITTLE RIVER, SC 29566-0635
(843) 249-4092
(843) 249-1638
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2537
SC
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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