Individual
MICAH DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3925 MINNESOTA AVE NE, WASHINGTON, DC 20019-2662
(312) 274-4530
Mailing address
6711 S SEPULVEDA BLVD, LOS ANGELES, CA 90045-2782
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401419305
VA
122300000X
Dentist
DEN2000422
DC
Other
Enumeration date
11/20/2023
Last updated
03/11/2025
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