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General NPI Number Information
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NPI Number | 1528065901
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Entity Type | Individual
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Provider Name | RONALD DAVID VENEZIE DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 504 W WILLIAMS ST
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City | APEX
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State | NC
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Zip | 27502-1846
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Country | US
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Telephone | 919-303-2873
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Fax |
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Provider Business Mailing Address
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Address Line | 504 W WILLIAMS ST
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City | APEX
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State | NC
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Zip | 27502-1846
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Country | US
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Telephone | 919-303-2873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 5964
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License Number State | NC
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