Individual
DR. CLAYTON GRAY HICKS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(240) 857-5029
Mailing address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(240) 857-5029
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3693
SC
1223P0221X
Pediatric Dentistry
Primary
10471
SC
1223P0221X
Pediatric Dentistry
Primary
3693
SC
Other
Enumeration date
09/15/2005
Last updated
06/26/2026
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