Provider Demographics
NPI:1669766218
Name:HOKE ROAD DENTAL, NANCY F, SNYDER DMD INC,
Entity type:Organization
Organization Name:HOKE ROAD DENTAL, NANCY F, SNYDER DMD INC,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:F
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:419-890-9978
Mailing Address - Street 1:5641 W STATE ROUTE 12
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-9394
Mailing Address - Country:US
Mailing Address - Phone:419-890-9978
Mailing Address - Fax:419-859-2011
Practice Address - Street 1:7701 HOKE RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:OH
Practice Address - Zip Code:45315-9725
Practice Address - Country:US
Practice Address - Phone:937-832-8000
Practice Address - Fax:937-832-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH22548122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2766190Medicaid