Organization
COLLEEN C HICKLE, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN C GACKOWSKI DDS (OWNER)
(216) 464-0500
Entity
Organization
Contact information
Practice address
3690 ORANGE PL STE 550, BEACHWOOD, OH 44122-4475
(216) 464-0500
(216) 464-0573
Mailing address
3690 ORANGE PL STE 550, BEACHWOOD, OH 44122-4475
(216) 464-0500
(216) 464-0573
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
21356
OH
Other
Enumeration date
04/09/2015
Last updated
07/13/2017
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