Provider Demographics
NPI:1518374123
Name:SNYDER, BENJAMIN DEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:DEAN
Last Name:SNYDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 ARCADIA PL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2814
Mailing Address - Country:US
Mailing Address - Phone:719-651-1545
Mailing Address - Fax:
Practice Address - Street 1:4425 VENETUCCI BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4013
Practice Address - Country:US
Practice Address - Phone:719-651-1545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003075152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist