Provider Demographics
NPI:1740368190
Name:VENEZIA, HARRY D (DDS)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:D
Last Name:VENEZIA
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 1:1212 GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2466
Mailing Address - Country:US
Mailing Address - Phone:610-277-1695
Mailing Address - Fax:
Practice Address - Street 1:1212 GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2466
Practice Address - Country:US
Practice Address - Phone:610-277-1695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015268L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice