Individual
DR. CLAYTON GRAY HICKS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 292-0748
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3693
SC
1223P0221X
Pediatric Dentistry
Primary
3693
SC
Other
Enumeration date
09/15/2005
Last updated
12/28/2020
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