Provider Demographics
NPI:1093986382
Name:VENTURA DENTAL SPECIALTY GROUP
Entity Type:Organization
Organization Name:VENTURA DENTAL SPECIALTY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:P
Authorized Official - Last Name:SATINOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:805-658-0700
Mailing Address - Street 1:3390 LOMA VISTA RD
Mailing Address - Street 2:SUITE#C
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3078
Mailing Address - Country:US
Mailing Address - Phone:805-658-0700
Mailing Address - Fax:805-658-0777
Practice Address - Street 1:3390 LOMA VISTA RD
Practice Address - Street 2:SUITE#C
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3078
Practice Address - Country:US
Practice Address - Phone:805-658-0700
Practice Address - Fax:805-658-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty