Provider Demographics
NPI:1528293321
Name:VENTO, CHARLES FRANK (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FRANK
Last Name:VENTO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 NORTHVIEW RD UNIT 78
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-2036
Mailing Address - Country:US
Mailing Address - Phone:414-659-0691
Mailing Address - Fax:
Practice Address - Street 1:1210 MARSH VIEW DR
Practice Address - Street 2:
Practice Address - City:MUKWONAGO
Practice Address - State:WI
Practice Address - Zip Code:53149-7700
Practice Address - Country:US
Practice Address - Phone:262-363-4041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6376-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist