Provider Demographics
NPI:1710911870
Name:SNOWDEN, BROOKE RACHELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:RACHELL
Last Name:SNOWDEN
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 1:7200 S PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-3336
Mailing Address - Country:US
Mailing Address - Phone:405-681-6668
Mailing Address - Fax:
Practice Address - Street 1:7200 S PENNSYLVANIA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-3336
Practice Address - Country:US
Practice Address - Phone:405-681-6668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5798122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist