Individual
PEGGY LEE DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
300 TUSKEGEE BLVD, DOVER AFB, DE 19902-5003
(918) 607-9166
Mailing address
436TH MEDICAL GROUP, DOVER AFB, DE 19902-5300
(918) 607-9166
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5375
OK
1223G0001X
General Practice Dentistry
Primary
5375
OK
Other
Enumeration date
04/14/2006
Last updated
05/19/2022
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