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General NPI Number Information
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NPI Number | 1518440114
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Entity Type | Organization
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Legal Business Name | VENUTO FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 813 ERIAL NEW BROOKLYN RD
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-3278
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Country | US
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Telephone | 856-784-9774
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Fax | 856-784-9474
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Provider Business Mailing Address
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Address Line | 813 NEW BROOKLYN -ERIAL ROAD
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-3278
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Country | US
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Telephone | 856-784-9774
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Fax | 856-784-9474
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Authorized Official
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Title or Position | ADDMINISTRAITON
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Name | ANN SECREST
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Credential |
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Telephone | 856-784-9774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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