Individual
DR. KEVIN JOHN FAIRCLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
513 FOUR MILE POST RD SE, HUNTSVILLE, AL 35802-2345
(256) 503-4693
Mailing address
513 FOUR MILE POST RD SE, HUNTSVILLE, AL 35802-2345
(256) 503-4693
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3843
AL
Other
Enumeration date
08/29/2008
Last updated
04/17/2015
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