Provider Demographics
NPI:1598873853
Name:WICK, ROBERT V (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:V
Last Name:WICK
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:19682 HESPERIAN BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4752
Mailing Address - Country:US
Mailing Address - Phone:510-782-1444
Mailing Address - Fax:510-782-3694
Practice Address - Street 1:19682 HESPERIAN BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4752
Practice Address - Country:US
Practice Address - Phone:510-782-1444
Practice Address - Fax:510-782-3694
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2021-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA22565122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist