Provider Demographics
NPI:1174511240
Name:R.SNITZER DENTAL, L.L.C.
Entity Type:Organization
Organization Name:R.SNITZER DENTAL, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SNITZER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:314-241-0885
Mailing Address - Street 1:1714 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1721
Mailing Address - Country:US
Mailing Address - Phone:314-241-0885
Mailing Address - Fax:314-241-0046
Practice Address - Street 1:1714 OLIVE ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1721
Practice Address - Country:US
Practice Address - Phone:314-241-0885
Practice Address - Fax:314-241-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO014727122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty