Individual
DR. DALLAS HALE HICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1615 HILL RD, STE. 12, NOVATO, CA 94947-4340
(415) 892-1564
(415) 892-1566
Mailing address
1615 HILL RD, STE. 12, NOVATO, CA 94947-4340
(415) 892-1564
(415) 892-1566
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
29153
CA
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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