Individual
JONATHAN MARC HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
377 W PALMETTO ST, FLORENCE, SC 29501
(843) 662-2543
(843) 656-0110
Mailing address
377 W PALMETTO ST, FLORENCE, SC 29501
(843) 662-2543
(843) 656-0110
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
SC2922
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LZ29229
—
SC
Enumeration date
10/23/2006
Last updated
07/08/2007
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