| NPI | 1740466572 |
|---|---|
| Doing Business As | VENETIAN SQUARE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | JEFFREY PHEN Dentist 209-474-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 44988) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2010-07-08 |