MEDICARE: DR. JOHN LEON SNUGGS JR. DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	4925	LA

General Provider Information

NPI Number	:	1669539730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LEON SNUGGS JR. DMD

Provider Business Mailing Address
First Line	:	3809 WHITES FERRY RD
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-2006
Country	:	US
Telephone Number	:	318-396-6204
Fax Number	:	318-396-9625

Provider Business Practice Location Address
First Line	:	3809 WHITES FERRY RD
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-2006
Country	:	US
Telephone Number	:	318-396-6204
Fax Number	:	318-396-9625

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	07/08/2007

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