Provider Demographics
NPI:1346423852
Name:MARKO VENNE DDS PC
Entity Type:Organization
Organization Name:MARKO VENNE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-874-8919
Mailing Address - Street 1:186 ARTHUR WAY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-9443
Mailing Address - Country:US
Mailing Address - Phone:757-874-8919
Mailing Address - Fax:757-874-3286
Practice Address - Street 1:186 ARTHUR WAY
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-9443
Practice Address - Country:US
Practice Address - Phone:757-874-8919
Practice Address - Fax:757-874-3286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04001007788305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1033203641OtherDENTIST INDIVIDUAL