Provider Demographics
NPI:1760515209
Name:STEPHEN C. SNITZER, D.D.S., M.S., P.C.
Entity Type:Organization
Organization Name:STEPHEN C. SNITZER, D.D.S., M.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SNITZER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:314-434-2101
Mailing Address - Street 1:14377 WOODLAKE DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5735
Mailing Address - Country:US
Mailing Address - Phone:314-434-2101
Mailing Address - Fax:
Practice Address - Street 1:14377 WOODLAKE DR
Practice Address - Street 2:SUITE 214
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5735
Practice Address - Country:US
Practice Address - Phone:314-434-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO130201223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty