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Organization

KIDSMILE, INC. - JOHN M. VENZEL, D.M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN MATTHEW VENZEL D.M.D. (MEMBER)
(440) 934-2600
Entity
Organization

Contact information

Practice address
37701 COLORADO AVE, SUITE E, AVON, OH 44011-2840
(440) 934-2600
(440) 934-2602
Mailing address
37701 COLORADO AVE, SUITE E, AVON, OH 44011-2840
(440) 934-2600
(440) 934-2602

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30.017951
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0603716
OH
01
603882
COMPBENEFITS PROVIDER ID
OH
01
774120
UNITED CONCORDIA PROVIDER
OH
Enumeration date
02/24/2006
Last updated
08/22/2020
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