Individual
CHRISTOPHER J HICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1861 E MADISON AVE STE 400, DERBY, KS 67037-2166
(316) 789-6200
(316) 361-2635
Mailing address
1356 LOOKOUT CIR, DERBY, KS 67037-9246
(316) 640-8761
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60354
KS
Other
Enumeration date
02/07/2006
Last updated
01/06/2022
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