Provider Demographics
NPI:1609183813
Name:SNOW ORTHODONTICS, P.C.
Entity Type:Organization
Organization Name:SNOW ORTHODONTICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:719-597-6800
Mailing Address - Street 1:7560 RANGEWOOD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-2100
Mailing Address - Country:US
Mailing Address - Phone:719-597-6800
Mailing Address - Fax:719-590-9407
Practice Address - Street 1:7560 RANGEWOOD DR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-2100
Practice Address - Country:US
Practice Address - Phone:719-597-6800
Practice Address - Fax:719-590-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO100341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty