Healthcare Provider Details

I. General information

NPI: 1912963737
Provider Name (Legal Business Name): SNYDER & DUGAN ORAL & MAXILLOFACIAL SURGERY P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 05/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 MCKNIGHT RD SUITE 201
PITTSBURGH PA
15237-6000
US

IV. Provider business mailing address

9401 MCKNIGHT RD SUITE 201
PITTSBURGH PA
15237-6000
US

V. Phone/Fax

Practice location:
  • Phone: 412-366-2090
  • Fax: 412-366-3477
Mailing address:
  • Phone: 412-366-2090
  • Fax: 412-366-3477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOYCE PERRY
Title or Position: ACCOUNTS RECEIVABLE COORDINATOR
Credential:
Phone: 412-366-2090