Provider Demographics
NPI:1669577987
Name:VENNERI DENTAL GROUP PC
Entity type:Organization
Organization Name:VENNERI DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF CORP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VENNERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-675-4090
Mailing Address - Street 1:3040 E COUNTY LN RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040
Mailing Address - Country:US
Mailing Address - Phone:215-675-4090
Mailing Address - Fax:215-675-9059
Practice Address - Street 1:3040 E COUNTY LN RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040
Practice Address - Country:US
Practice Address - Phone:215-675-4090
Practice Address - Fax:215-675-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS013110L122300000X
PADS025876L122300000X
PADS026858L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty