Provider Demographics
NPI:1093985665
Name:SNIDOW, CONLEY TRIGG III (DDS)
Entity Type:Individual
Prefix:DR
First Name:CONLEY
Middle Name:TRIGG
Last Name:SNIDOW
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 HUGUENOT ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2478
Mailing Address - Country:US
Mailing Address - Phone:804-379-9399
Mailing Address - Fax:804-379-8401
Practice Address - Street 1:1500 HUGUENOT ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2478
Practice Address - Country:US
Practice Address - Phone:804-379-9399
Practice Address - Fax:804-379-8401
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010036681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice