1982996252 NPI number — NANCY F. SNYDER DMD INC.

Table of content: (NPI 1982996252)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982996252 NPI number — NANCY F. SNYDER DMD INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NANCY F. SNYDER DMD INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982996252
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5641 W STATE ROUTE 12
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FINDLAY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45840-9394
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-890-9978
Provider Business Mailing Address Fax Number:
419-859-2011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1496 SOUTHGATE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YELLOW SPRINGS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45387-1244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-767-8000
Provider Business Practice Location Address Fax Number:
937-767-2542
Provider Enumeration Date:
05/05/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SNYDER
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
FAE
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
419-890-9978

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  30022548 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2766190 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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