| Venice Village Dental | |
|
4153 Unit B South Tamiami Trail Venice FL 34293 | |
| (941) 408-7645 | |
| (941) 408-7660 |
| Full Name | Venice Village Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4153 Unit B South Tamiami Trail, Venice, Florida |
| Authorized Official Name and Position | Timothy Keith Riesz (PRESIDENT) |
| Authorized Official Contact | 9414087645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Venice Village Dental 4153 Unit B South Tamiami Trail Venice FL 34293 Ph: (941) 408-7645 | Venice Village Dental 4153 Unit B South Tamiami Trail Venice FL 34293 Ph: (941) 408-7645 |
| NPI Number | 1609164011 |
|---|---|
| Provider Enumeration Date | 07/19/2011 |
| Last Update Date | 07/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609164011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN15792 (Florida) | Primary |
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