# IMPLANT DENTISTRY OF VENICE LLC

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

## Provider details

- **NPI number:** 1871681692
- **Authorized official:** DR. DAVID M CHAMPION (PRESIDENT)
- **Authorized official phone:** (941) 497-1585

## Contact information

- **Practice address:** 1515 TAMIAMI TRAIL S, SUITE 3, VENICE, FL 34285
- **Practice address phone:** (941) 497-1585
- **Practice address fax:** (941) 496-7905
- **Mailing address:** 1515 TAMIAMI TRAIL S, SUITE 3, VENICE, FL 34285
- **Mailing address phone:** (941) 497-1585
- **Mailing address fax:** (941) 496-7905

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 6743 | FL | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 08/22/2020