Individual
BRADEN PAUL HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
108 WHIPPLE ST, PRESCOTT, AZ 86301-1706
(928) 445-6030
(928) 445-6085
Mailing address
108 WHIPPLE ST, PRESCOTT, AZ 86301-1706
(928) 445-6030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D010454
AZ
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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