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Individual
MARY HICKERSON
Active
Individual
MARY HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
19470
MT
122300000X
Dentist
DN28849
FL
1223G0001X
General Practice Dentistry
Primary
19470
MT
1223G0001X
General Practice Dentistry
36313
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UNAVAILABLE
UNAVAILABLE
—
Enumeration date
07/14/2020
Last updated
04/30/2025
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