Provider Demographics
NPI:1598259129
Name:SNOOK, RACHEL IUSTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:IUSTER
Last Name:SNOOK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ROUND TABLE RD
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-7710
Mailing Address - Country:US
Mailing Address - Phone:508-688-7262
Mailing Address - Fax:
Practice Address - Street 1:126 UNION ST OFC 1
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1207
Practice Address - Country:US
Practice Address - Phone:508-481-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MADN18582481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program