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General NPI Number Information
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NPI Number | 1407733587
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Entity Type | Organization
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Legal Business Name | SNOW PALMDALE DENTAL OFFICE INC.
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 868 AUTO CENTER DR STE D
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City | PALMDALE
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State | CA
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Zip | 93551-4690
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Country | US
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Telephone | 661-945-2616
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Fax |
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Provider Business Mailing Address
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Address Line | 868 AUTO CENTER DR STE D
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City | PALMDALE
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State | CA
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Zip | 93551-4690
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Country | US
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Telephone | 661-945-2616
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | GLENN LAMONT HORN
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Credential |
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Telephone | 661-609-0235
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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 |
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License Number State |
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