Provider Demographics
NPI:1356417307
Name:SNYDER, GLENN DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:DAVID
Last Name:SNYDER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 ARDMORE BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-4652
Mailing Address - Country:US
Mailing Address - Phone:412-271-5050
Mailing Address - Fax:412-271-5051
Practice Address - Street 1:2030 ARDMORE BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4652
Practice Address - Country:US
Practice Address - Phone:412-271-5050
Practice Address - Fax:412-271-5051
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024153L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice