Individual
DR. RICHARD K. VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
7015 HALCYON PARK DR, MONTGOMERY, AL 36117-7763
(334) 284-1100
(334) 281-1245
Mailing address
7015 HALCYON PARK DR, MONTGOMERY, AL 36117-7763
(334) 284-1100
(334) 281-1245
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3068
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009921645
—
AL
01
—
51515480
BCBS PROVIDER NUMBER
AL
Enumeration date
08/29/2006
Last updated
07/09/2007
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