Provider Demographics
NPI:1154816064
Name:WANNINGER, WILLIAM ANTON (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANTON
Last Name:WANNINGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1584 THIN PINE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-8796
Mailing Address - Country:US
Mailing Address - Phone:205-369-3424
Mailing Address - Fax:
Practice Address - Street 1:2636 HIGHWAY 17A S STE A
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-9114
Practice Address - Country:US
Practice Address - Phone:843-242-0645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist