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General NPI Number Information
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NPI Number | 1487880647
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Entity Type | Organization
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Legal Business Name | CHARLES R. VENNERI, D.M.D.
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 110 DANIEL DR SUITE 3
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City | UNIONTOWN
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State | PA
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Zip | 15401-8002
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Country | US
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Telephone | 724-437-0937
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Fax | 724-437-1708
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Provider Business Mailing Address
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Address Line | 110 DANIEL DR SUITE 3
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City | UNIONTOWN
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State | PA
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Zip | 15401-8002
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Country | US
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Telephone | 724-437-0937
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Fax | 724-437-1708
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES R VENNERI
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Credential | D.M.D.
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Telephone | 724-437-0937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS022954L
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License Number State | PA
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