Individual
DR. TRAVIS ALAN HICKOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
50 N MEDICAL DR, SLC, UT 84132-0001
(801) 581-2220
Mailing address
4889 WOODHAVEN DR, TAYLORSVILLE, UT 84123-4378
(801) 541-2482
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7028948
UT
Other
Enumeration date
11/10/2008
Last updated
11/10/2008
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