Provider Demographics
NPI:1366636896
Name:IDAN SNAPIR DDS INC
Entity Type:Organization
Organization Name:IDAN SNAPIR DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SNAPIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-780-9700
Mailing Address - Street 1:15704 1/2 VANOWEN ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-5029
Mailing Address - Country:US
Mailing Address - Phone:818-780-9700
Mailing Address - Fax:
Practice Address - Street 1:15704 1/2 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-5029
Practice Address - Country:US
Practice Address - Phone:818-780-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA454101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty