Healthcare Provider Details

I. General information

NPI: 1639626146
Provider Name (Legal Business Name): PAULA SNYDER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E RAILROAD ST
PLAINS MT
59859-0837
US

IV. Provider business mailing address

PO BOX 1611
PLAINS MT
59859-1611
US

V. Phone/Fax

Practice location:
  • Phone: 406-826-3611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1014
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: