Provider Demographics
NPI:1588838429
Name:SNIDER, LAWRENCE A (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:SNIDER
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 1:6707 OLD DOMINION DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4504
Mailing Address - Country:US
Mailing Address - Phone:703-893-1000
Mailing Address - Fax:703-893-1024
Practice Address - Street 1:6707 OLD DOMINION DR
Practice Address - Street 2:SUITE 250
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4504
Practice Address - Country:US
Practice Address - Phone:703-893-1000
Practice Address - Fax:703-893-1024
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401-0055961223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics