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General NPI Number Information
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NPI Number | 1902073042
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Entity Type | Individual
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Provider Name | KEVIN G SNYDER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 6173 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-2679
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Country | US
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Telephone | 352-795-1074
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Fax | 352-795-3310
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Provider Business Mailing Address
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Address Line | 6173 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-2679
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Country | US
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Telephone | 352-795-1074
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Fax | 352-795-3310
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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 | DN0011881
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License Number State | FL
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