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1932629953
JORDAN KING ALEXIS HICKS
PORTLAND, ME
NPI
1932629953
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: ME DEN4543)
Enumeration Date
2017-06-21
Last Update Date
2018-03-17
Business Address
Dr. JORDAN KING ALEXIS HICKS DDS
612 BRIGHTON AVE
PORTLAND, ME 04102-2359
Phone number: 207-772-4359
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Mailing Address
Dr. JORDAN KING ALEXIS HICKS DDS
612 BRIGHTON AVE
PORTLAND, ME 04102-2359
Phone number:
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