Healthcare Provider Details

I. General information

NPI: 1518046903
Provider Name (Legal Business Name): JOSEPH ANDREW SNYDER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 07/08/2007
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: 505-439-0446
  • Fax: 505-439-0622
Mailing address:
  • Phone: 505-439-0446
  • Fax: 505-439-0622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1364
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: