Provider Demographics
NPI:1639192776
Name:SNYDER, PATRICK MICHEAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MICHEAL
Last Name:SNYDER
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 1:777 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-3508
Mailing Address - Country:US
Mailing Address - Phone:715-723-0366
Mailing Address - Fax:715-723-4635
Practice Address - Street 1:777 E PARK AVE
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3508
Practice Address - Country:US
Practice Address - Phone:715-723-0366
Practice Address - Fax:715-723-4635
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5001705G1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice