Healthcare Provider Details

I. General information

NPI: 1508032608
Provider Name (Legal Business Name): JOSEPH SNYDER, D.D.S. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2832 INDIAN WELLS RD
ALAMOGORDO NM
88310-3861
US

IV. Provider business mailing address

2832 INDIAN WELLS RD
ALAMOGORDO NM
88310-3861
US

V. Phone/Fax

Practice location:
  • Phone: 575-439-0446
  • Fax: 575-439-0622
Mailing address:
  • Phone: 575-439-0446
  • Fax: 575-439-0622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1364
License Number StateNM

VIII. Authorized Official

Name: DR. JOSEPH ANDREW SNYDER
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 575-439-0446