Provider Demographics
NPI:1134153281
Name:SNYDER, ALVIN JEROME (DDS)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:JEROME
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 1:324 N SAN MATEO DR
Mailing Address - Street 2:#2
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2514
Mailing Address - Country:US
Mailing Address - Phone:650-344-8818
Mailing Address - Fax:650-344-0296
Practice Address - Street 1:324 N SAN MATEO DR
Practice Address - Street 2:#2
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2514
Practice Address - Country:US
Practice Address - Phone:650-344-8818
Practice Address - Fax:650-344-0296
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD202711223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics