Individual
DR. DAVID JOHN WICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
133 STATE ST, AUGUSTA, ME 04330-5613
(207) 622-2400
Mailing address
PO BOX 2717, BANGOR, ME 04402-2717
(207) 973-3953
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
ME 3095
ME
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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