Provider Demographics
NPI:1740303536
Name:DOVE FAMILY DENTISTRY PC
Entity type:Organization
Organization Name:DOVE FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WENTURINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-465-1433
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901014271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty