Healthcare Provider Details

I. General information

NPI: 1255647434
Provider Name (Legal Business Name): SUZANNE R SNOW DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 COLUMBIA POINT DR
RICHLAND WA
99352-4375
US

IV. Provider business mailing address

90 COLUMBIA POINT DR
RICHLAND WA
99352-4375
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-9313
  • Fax:
Mailing address:
  • Phone: 509-946-9313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10202
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE R SNOW
Title or Position: OWNER
Credential: DDS
Phone: 509-946-9313