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General NPI Number Information
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NPI Number | 1598988644
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Entity Type | Organization
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Legal Business Name | KING & WIGGINS, D.M.D., P.A.
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2170 ASHLEY PHOSPHATE RD. SUITE 600
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-4194
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Country | US
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Telephone | 843-569-1717
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Fax | 843-569-6139
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Provider Business Mailing Address
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Address Line | 2170 ASHLEY PHOSPHATE RD. SUITE 600
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-4194
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Country | US
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Telephone | 843-569-1717
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Fax | 843-569-6139
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH T. KING
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Credential | D.M.D.
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Telephone | 843-569-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2663
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License Number State | SC
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