Individual
MRS. MIRANDA OLIVIA HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1960 N. OGDEN ST, STE 260, DENVER, CO 80218
(303) 529-6329
Mailing address
2233 GALENA ST., AURORA, CO 80010
(206) 769-0768
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00204667
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2020
Last updated
09/07/2021
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