Healthcare Provider Details

I. General information

NPI: 1477705044
Provider Name (Legal Business Name): HARRY DAVID SNYDMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9704B GROFFS MILL DR
OWINGS MILLS MD
21117-6341
US

IV. Provider business mailing address

9704B GROFFS MILL DR
OWINGS MILLS MD
21117-6341
US

V. Phone/Fax

Practice location:
  • Phone: 410-654-9696
  • Fax: 410-654-9686
Mailing address:
  • Phone: 410-654-9696
  • Fax: 410-654-9686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10340
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: