Healthcare Provider Details

I. General information

NPI: 1700897865
Provider Name (Legal Business Name): RONALD K SNYDER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 GILLMORE AVE SUITE B
RICHLAND WA
99352-3382
US

IV. Provider business mailing address

1050 GILLMORE AVE SUITE B
RICHLAND WA
99352-3382
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-2258
  • Fax: 509-946-1211
Mailing address:
  • Phone: 509-946-2258
  • Fax: 509-946-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6023
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: