Dr. Dallas Hale Hickle
Oral and Maxillofacial Surgeon
1615 Hill Rd Ste. 12
Novato
, California 94947-4340
Dr. Dallas Hale Hickle
Oral and Maxillofacial Surgeon
1615 Hill Rd Ste. 12
Novato
, California 94947-4340
(415) 892-1566
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Dallas Hale Hickle
- 1615 Hill Rd Ste. 12
- Novato, CA
- Zip : 94947-4340
- Fax : (415) 892-1566
- Phone : (415) 892-1564
Second Address
- Dr. Dallas Hale Hickle
- 1615 Hill Rd Ste. 12
- Novato, CA
- Zip : 94947-4340
- Fax : (415) 892-1566
- Phone : (415) 892-1564
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 29153 | CA |
National Provider Identifier
| NPI | 1033256227 |
|---|---|
| Provider Name | Dr. Dallas Hale Hickle |
| First Address | Novato, CA 94947-4340 |
| Second Address | Novato, CA 94947-4340 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/01/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.