Healthcare Provider Details

I. General information

NPI: 1790005155
Provider Name (Legal Business Name): DANIEL G SNOW D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7560 RANGEWOOD DR STE 100
COLORADO SPRINGS CO
80920-2100
US

IV. Provider business mailing address

7560 RANGEWOOD DR STE 100
COLORADO SPRINGS CO
80920-2100
US

V. Phone/Fax

Practice location:
  • Phone: 719-597-6800
  • Fax: 719-590-9407
Mailing address:
  • Phone: 719-597-6800
  • Fax: 719-590-9407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number10034
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: