Individual
DR. DENISE GAYLE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
905 SW RIMROCK WAY STE 201, REDMOND, OR 97756-2569
(541) 526-5661
(541) 526-1441
Mailing address
66855 FRYREAR RD, BEND, OR 97703-9193
(865) 335-4571
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9599
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500641734
—
OR
Enumeration date
07/18/2011
Last updated
12/18/2019
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