| Kidsmile, Inc. - John M. Venzel, D.m.d. | |
|
37701 Colorado Ave Suite E Avon OH 44011-2840 | |
| (440) 934-2600 | |
| (440) 934-2602 |
| Full Name | Kidsmile, Inc. - John M. Venzel, D.m.d. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 37701 Colorado Ave, Avon, Ohio |
| Authorized Official Name and Position | John Matthew Venzel (MEMBER) |
| Authorized Official Contact | 4409342600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidsmile, Inc. - John M. Venzel, D.m.d. 37701 Colorado Ave Suite E Avon OH 44011-2840 Ph: (440) 934-2600 | Kidsmile, Inc. - John M. Venzel, D.m.d. 37701 Colorado Ave Suite E Avon OH 44011-2840 Ph: (440) 934-2600 |
| NPI Number | 1447226998 |
|---|---|
| Provider Enumeration Date | 02/24/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447226998 | NPI | - | NPPES |
| 0603716 | Medicaid | OH | |
| 774120 | Other | OH | UNITED CONCORDIA PROVIDER |
| 603882 | Other | OH | COMPBENEFITS PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 30.017951 (Ohio) | Primary |
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