Provider Demographics
NPI:1558529800
Name:SNOW, JAMES SIDNEY III (D M D)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SIDNEY
Last Name:SNOW
Suffix:III
Gender:M
Credentials:D M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 WILMINGTON RD
Mailing Address - Street 2:P. O. BOX 5008
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1547
Mailing Address - Country:US
Mailing Address - Phone:724-654-6050
Mailing Address - Fax:724-657-9032
Practice Address - Street 1:2628 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1547
Practice Address - Country:US
Practice Address - Phone:724-654-6050
Practice Address - Fax:724-657-9032
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023063L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice