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: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40958 US HIGHWAY 19 N
TARPON SPRINGS FL
34689-5446
US

IV. Provider business mailing address

135 LARGS CT APT 101
DUNEDIN FL
34698-8386
US

V. Phone/Fax

Practice location:
  • Phone: 727-605-7639
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN27532
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: