Provider Demographics
NPI:1598003261
Name:SNYDER, LUISA (DMD)
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 COMMERCIAL ST. S.E.
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302
Mailing Address - Country:US
Mailing Address - Phone:503-362-8364
Mailing Address - Fax:503-378-0853
Practice Address - Street 1:1524 COMMERCIAL ST. S.E.
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302
Practice Address - Country:US
Practice Address - Phone:503-362-8364
Practice Address - Fax:503-378-0853
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10063122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist