Individual
DR. GENE ALLEN VANDERVORT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S./M.D.
Contact information
Practice address
44340 PREMIER PLAZA, SUITE 100, ASHBURN, VA 20147-5074
(703) 729-8700
(703) 729-5300
Mailing address
44340 PREMIER PLAZA, SUITE 100, ASHBURN, VA 20147-5074
(703) 729-8700
(703) 729-5300
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
0101102662
VA
Other
Enumeration date
02/21/2006
Last updated
07/09/2009
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