Individual
MR. CHARLES MICHAEL HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
959 LINCOLN HWY, FAIRVIEW HEIGHTS, IL 62208-2234
(618) 624-2500
Mailing address
959 LINCOLN HWY, FAIRVIEW HEIGHTS, IL 62208-2234
(618) 624-2500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
IL
Other
Enumeration date
09/08/2006
Last updated
09/11/2025
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