# VENEMAN DENTAL CARE, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336560275
- **Authorized official:** DR. DERRICK JOHN VENEMAN DDS (PRESIDENT)
- **Authorized official phone:** (651) 770-7175

## Contact information

- **Practice address:** 1774 COPE AVE, SUITE 110, MAPLEWOOD, MN 55109
- **Practice address phone:** (651) 770-7175
- **Practice address fax:** (651) 770-6109
- **Mailing address:** 1774 COPE AVE, SUITE 110, MAPLEWOOD, MN 55109
- **Mailing address phone:** (651) 770-7175
- **Mailing address fax:** (651) 770-6109

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 10146 | MN | Yes |

## Other

- **Enumeration date:** 12/19/2013
- **Last updated:** 12/19/2013