Provider Demographics
NPI:1346450962
Name:GREGORY SCOTT HICKEY DD.S., P.C.
Entity Type:Organization
Organization Name:GREGORY SCOTT HICKEY DD.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICER
Authorized Official - Phone:713-822-5172
Mailing Address - Street 1:16000 STUEBNER AIRLINE RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379
Mailing Address - Country:US
Mailing Address - Phone:281-376-4406
Mailing Address - Fax:281-376-4489
Practice Address - Street 1:16000 STUEBNER AIRLINE RD
Practice Address - Street 2:SUITE 115
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379
Practice Address - Country:US
Practice Address - Phone:281-376-4406
Practice Address - Fax:281-376-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty