Healthcare Provider Details

I. General information

NPI: 1629197330
Provider Name (Legal Business Name): JAMES CLIFTON SNYDER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S RAYMOND AVE #4B
FULLERTON CA
92831-5201
US

IV. Provider business mailing address

55 CASTANO
RANCHO SANTA MARGARITA CA
92688-1663
US

V. Phone/Fax

Practice location:
  • Phone: 714-992-2999
  • Fax:
Mailing address:
  • Phone: 949-589-9377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number24250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: