Individual provider · Type 1 NPI

Mary Hickerson, DDS

General Practice Dentistry · Eglin Afb, FL

NPI number 1487262697 Active

Practice location

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000XDN28849 (FL)
General Practice Dentistry Primary 1223G0001X19470 (MT)
Dentist 122300000X19470 (MT)
General Practice Dentistry 1223G0001X36313 (TX)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1487262697

Mary Hickerson, DDS's National Provider Identifier is 1487262697, issued on Jul 14, 2020. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Eglin Afb, FL. The record was last updated on Apr 30, 2025.