Provider Demographics
NPI:1245393628
Name:SNIDER, HOWARD LEE JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:LEE
Last Name:SNIDER
Suffix:JR
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 1:4103 MAID STONE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4031
Mailing Address - Country:US
Mailing Address - Phone:337-474-1375
Mailing Address - Fax:
Practice Address - Street 1:202 S HOLLY ST
Practice Address - Street 2:
Practice Address - City:DEQUINCY
Practice Address - State:LA
Practice Address - Zip Code:70633-3526
Practice Address - Country:US
Practice Address - Phone:337-786-2146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA38901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice