Provider Demographics
NPI:1205924438
Name:SNAPP, JASON PERRY (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:PERRY
Last Name:SNAPP
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 1:228 E LAVEROCK RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1825
Mailing Address - Country:US
Mailing Address - Phone:317-850-4580
Mailing Address - Fax:
Practice Address - Street 1:1709 TEAL RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-2549
Practice Address - Country:US
Practice Address - Phone:765-477-6487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120103891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice