Healthcare Provider Details

I. General information

NPI: 1770641813
Provider Name (Legal Business Name): WILLIAM C SNYDER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 PADANARAM RD DENTAL ASSOCIATES OF CT PC
DANBURY CT
06811
US

IV. Provider business mailing address

36 PADANARAM RD DENTAL ASSOCIATES OF CT PC
DANBURY CT
06811
US

V. Phone/Fax

Practice location:
  • Phone: 203-748-5717
  • Fax: 203-748-4340
Mailing address:
  • Phone: 203-748-5717
  • Fax: 203-748-4340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4352
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: