Provider Demographics
NPI:1669622312
Name:SNAN LP
Entity type:Organization
Organization Name:SNAN LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SALBA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-444-1755
Mailing Address - Street 1:13303 CHAMPION FOREST DRIVE
Mailing Address - Street 2:BUILDING #5
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069
Mailing Address - Country:US
Mailing Address - Phone:281-444-1755
Mailing Address - Fax:281-444-1314
Practice Address - Street 1:13303 CHAMPION FOREST DRIVE
Practice Address - Street 2:BUILDING #5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069
Practice Address - Country:US
Practice Address - Phone:281-444-1755
Practice Address - Fax:281-444-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193691223G0001X
TX187591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty