Healthcare Provider Details

I. General information

NPI: 1750769931
Provider Name (Legal Business Name): MELISSA SNYDER RDH, BASDH, M.ED., P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10729 DINGMAN RD
GUYS MILLS PA
16327-2315
US

IV. Provider business mailing address

10729 DINGMAN RD
GUYS MILLS PA
16327-2315
US

V. Phone/Fax

Practice location:
  • Phone: 814-571-3106
  • Fax:
Mailing address:
  • Phone: 814-571-3106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH069736
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: