Individual
JENNIFER HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
500 N ESTRELLA PKWY STE B1, GOODYEAR, AZ 85338-4136
(623) 882-0782
Mailing address
744 E HAYWARD AVE, PHOENIX, AZ 85020-4149
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D012134
AZ
1223G0001X
General Practice Dentistry
Primary
D012134
AZ
Other
Enumeration date
05/20/2024
Last updated
08/03/2026
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