Provider Demographics
NPI:1558374769
Name:SNIEGOWSKI, THOMAS WALTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WALTER
Last Name:SNIEGOWSKI
Suffix:
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 1:7475 DAKIN STREET
Mailing Address - Street 2:STE 309
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-6926
Mailing Address - Country:US
Mailing Address - Phone:303-429-2727
Mailing Address - Fax:303-429-1505
Practice Address - Street 1:7475 DAKIN STREET
Practice Address - Street 2:STE 309
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-6926
Practice Address - Country:US
Practice Address - Phone:303-429-2727
Practice Address - Fax:303-429-1505
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD109051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO100905OtherCOLO BUD OF DENTISTRY