Organization
HICKS DENTAL CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE GAYLE HICKS DDS (PRESIDENT/DENTIST)
(865) 335-4571
Entity
Organization
Contact information
Practice address
905 SW RIMROCK WAY STE 201, REDMOND, OR 97756-2569
(541) 526-5661
Mailing address
66855 FRYREAR RD, BEND, OR 97703-9193
(865) 335-4571
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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