Individual
JONATHAN HUNTER HICKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1803 AUGUSTA ST STE A, GREENVILLE, SC 29605-2980
(864) 272-3091
(864) 272-3093
Mailing address
1803 AUGUSTA ST STE A, GREENVILLE, SC 29605-2980
(864) 272-3091
(864) 272-3093
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4685
SC
Other
Enumeration date
05/06/2009
Last updated
08/06/2012
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