Individual
DR. KENNETH LUCKIE VANDERVOORT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1117 GLADSTONE AVE, BIRMINGHAM, AL 35213-1415
(256) 239-3890
Mailing address
1117 GLADSTONE AVE, BIRMINGHAM, AL 35213-1415
(256) 239-3890
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5923
AL
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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