# TERRY A HICKEY DDS PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811013949
- **Authorized official:** DR. TERRY ALLEN HICKEY DDS, PS (OWNER)
- **Authorized official phone:** (253) 475-8990

## Contact information

- **Practice address:** 6919 LAKEWOOD DR W STE D4, TACOMA, WA 98467-3220
- **Practice address phone:** (253) 475-8990
- **Practice address fax:** (253) 475-5514
- **Mailing address:** 6919 LAKEWOOD DR W STE D4, TACOMA, WA 98467-3220
- **Mailing address phone:** (253) 475-8990
- **Mailing address fax:** (253) 475-5514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5796 | WA | Yes |

## Other

- **Enumeration date:** 03/21/2007
- **Last updated:** 12/04/2012