Healthcare Provider Details

I. General information

NPI: 1760669907
Provider Name (Legal Business Name): LISA SNAUFFER DUNSHEE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21633 AVENUE 24
CHOWCHILLA CA
93610
US

IV. Provider business mailing address

PO BOX 99
CHOWCHILLA CA
93610
US

V. Phone/Fax

Practice location:
  • Phone: 559-665-6100
  • Fax: 559-665-6166
Mailing address:
  • Phone: 559-665-6100
  • Fax: 559-665-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number31864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: