DR. Kenneth Wayne Vansickle JR., D.M.D
NPI #1033196118 in Santa Fe, New Mexico
Provider Information
- NPI Number
- 1033196118
- Entity Type
- Individual
- Name
- DR. Kenneth Wayne Vansickle JR., D.M.D
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- D.M.D
- Enumeration Date
- Dec 29, 2005
- Last Updated
- Apr 23, 2013
Practice Location
- Address
- 2008 SAINT MICHAELS DR
- Address 2
- SUITE B
- City
- Santa Fe
- State
- New Mexico
- ZIP Code
- 87505-7682
- Phone
- (505) 474-4993
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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