Provider Demographics
NPI:1720157530
Name:VENDITTO DENTAL ASSOC
Entity Type:Organization
Organization Name:VENDITTO DENTAL ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MAN SEC TREAS
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAUREE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VENDITTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-905-7706
Mailing Address - Street 1:475 RT 70 WEST STE 102
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-905-7706
Mailing Address - Fax:732-905-4171
Practice Address - Street 1:475 RT 70 WEST STE 102
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-905-7706
Practice Address - Fax:732-905-4171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty