| NPI | 1609164011 |
|---|---|
| Doing Business As | VENICE VILLAGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY KEITH RIESZ President 941-408-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN15792) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |