Individual
DR. MATTHEW ROBERT HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6200 SE MILWAUKIE AVE, PORTLAND, OR 97202-5417
(503) 235-7000
Mailing address
6200 SE MILWAUKIE AVE, PORTLAND, OR 97202-5417
(503) 235-7000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7302
OR
Other
Enumeration date
07/02/2005
Last updated
07/08/2007
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