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NPI 1174690689

NPI 1174690689 : LARRY SNYDER D.M.D. : RHINEBECK, NY

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General NPI Number Information
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    NPI Number           |    1174690689
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    Entity Type          |    Individual 
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    Provider Name        |    LARRY SNYDER D.M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/29/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    6811 ROUTE 9 
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    City                 |    RHINEBECK
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    State                |    NY
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    Zip                  |    12572-1150
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    Country              |    US
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    Telephone            |    845-876-2628
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    Fax                  |    845-876-8724
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Provider Business Mailing Address
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    Address Line         |    6811 ROUTE 9 
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    City                 |    RHINEBECK
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    State                |    NY
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    Zip                  |    12572-1150
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    Country              |    US
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    Telephone            |    845-876-2628
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    Fax                  |    845-876-8724
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    036089
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    License Number State |    NY
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