Organization
PATRIOT DENTAL SNEAD LLC
Active
Other names
Kenneth Luckie Vandervoort DMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH LUCKIE VANDERVOORT JR. DMD (OWNER)
(205) 466-7188
Entity
Organization
Contact information
Practice address
88223 US HIGHWAY 278, SNEAD, AL 35952-9643
(205) 466-7188
(205) 466-8188
Mailing address
PO BOX 627, SNEAD, AL 35952-0627
(205) 466-7188
(205) 466-8188
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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