Individual
DR. ALEXANDER XL HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7915 W USTICK RD, BOISE, ID 83704-5851
(208) 376-7599
Mailing address
7915 W USTICK RD, BOISE, ID 83704-5851
(208) 376-7599
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5515
ID
1223G0001X
General Practice Dentistry
D-5515
ID
Other
Enumeration date
06/06/2023
Last updated
10/30/2024
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