Provider Demographics
NPI:1518980382
Name:SNIDER, DOUGLAS HOWARD (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:HOWARD
Last Name:SNIDER
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1074 EAST AVE
Mailing Address - Street 2:SUITE S
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1005
Mailing Address - Country:US
Mailing Address - Phone:530-891-3456
Mailing Address - Fax:530-891-8909
Practice Address - Street 1:1074 EAST AVE
Practice Address - Street 2:SUITE S
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1005
Practice Address - Country:US
Practice Address - Phone:530-891-3456
Practice Address - Fax:530-891-8909
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADN319811223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics