Individual
DR. STANLEY J HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
275 N FRONTAGE RD, FORSYTH, GA 31029-9556
(478) 992-9104
(478) 992-9105
Mailing address
275 N FRONTAGE RD, FORSYTH, GA 31029-9556
(478) 992-9104
(478) 992-9105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011865
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000931422A
—
GA
Enumeration date
10/11/2006
Last updated
03/05/2012
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