Individual
LUKE DAVID VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
103524
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D15159
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DT-2960
HI
Other
Enumeration date
03/02/2018
Last updated
06/25/2025
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