Individual
WALTER VENERABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5055 W RAY RD, STE 17, CHANDLER, AZ 85226-6108
(480) 893-2695
Mailing address
5055 W RAY RD, STE 17, CHANDLER, AZ 85226-6108
(480) 893-2695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3809
AZ
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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