DR. Kenneth Luckie Vandervoort JR., D.M.D.

NPI #1023361896 in Birmingham, Alabama

Provider Information

NPI Number: 1023361896
Entity Type: Individual
Name: DR. Kenneth Luckie Vandervoort JR., D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Oct 18, 2012
Last Updated: Oct 18, 2012

Practice Location

Address: 1117 GLADSTONE AVE
City: Birmingham
State: Alabama
ZIP Code: 35213-1415
Phone: (256) 239-3890

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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