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Individual

DR. JOHN MATTHEW VENZEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
37701 COLORADO AVE, SUITE E, AVON, OH 44011
(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
17951
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0603716
OH
01
341769458026
CARE SOURCE
OH
Enumeration date
05/08/2008
Last updated
06/06/2018
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