Provider Demographics
NPI:1568585354
Name:WENTURINE, JAMES A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:WENTURINE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37540 GRATIOT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-2795
Mailing Address - Country:US
Mailing Address - Phone:586-465-1433
Mailing Address - Fax:586-465-6258
Practice Address - Street 1:37540 GRATIOT
Practice Address - Street 2:SUITE 101
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-2795
Practice Address - Country:US
Practice Address - Phone:586-465-1433
Practice Address - Fax:586-465-6258
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901014271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist