Individual
CLARK BANKS HICKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
575 UNIVERSITY PKWY, SUITE A-24, OREM, UT 84097-7400
(801) 225-3300
(801) 764-9069
Mailing address
944 S 2500 E, SPRINGVILLE, UT 84663-3920
(801) 491-3207
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3446069922
UT
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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