Healthcare Provider Details
I. General information
NPI: 1346733243
Provider Name (Legal Business Name): MICHAEL JOHN SNYDER DDS AND BS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/14/2018
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5823 MAIN ST
NEW PORT RICHEY FL
34652-2713
US
IV. Provider business mailing address
8630 CAMPUS WOODS WAY
NEW PORT RICHEY FL
34655-4728
US
V. Phone/Fax
- Phone: 727-842-6052
- Fax: 727-843-8338
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DN27532 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: