Provider Demographics
NPI:1760029268
Name:HARBOUR DENTAL CARE, P.A.
Entity Type:Organization
Organization Name:HARBOUR DENTAL CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-940-8243
Mailing Address - Street 1:75 SAN MARCO AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-3257
Mailing Address - Country:US
Mailing Address - Phone:904-810-1002
Mailing Address - Fax:
Practice Address - Street 1:75 SAN MARCO AVE
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-3257
Practice Address - Country:US
Practice Address - Phone:904-810-1002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEVIN W SNYDER DDS, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental