Individual
KENNETH S.J. HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
7555 CENTER VIEW CT, SUITE 104, WEST JORDAN, UT 84084-1970
(801) 566-8540
(801) 255-7780
Mailing address
7555 S CENTER VIEW CT, SUITE 104, WEST JORDAN, UT 84084
(801) 566-8540
(801) 255-7780
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
264451-9922
UT
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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