Healthcare Provider Details
I. General information
NPI: 1043359714
Provider Name (Legal Business Name): ROBERT V SNYDERS JR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/06/2007
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7000 66TH STREET N
PINELLAS PARK FL
33781-4067
US
IV. Provider business mailing address
2189 CLEVELAND ST SUITE 252
CLEARWATER FL
33765-3213
US
V. Phone/Fax
- Phone: 727-546-4665
- Fax: 727-446-8382
- Phone: 727-461-9149
- Fax: 727-446-8382
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DN13680 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: