Provider Demographics
NPI:1831204783
Name:SNAVELY, RODNEY DUANE (DDS)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:DUANE
Last Name:SNAVELY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4411 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-3050
Mailing Address - Country:US
Mailing Address - Phone:515-279-0926
Mailing Address - Fax:515-279-5667
Practice Address - Street 1:3102 INGERSOLL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3910
Practice Address - Country:US
Practice Address - Phone:515-279-0926
Practice Address - Fax:515-279-5667
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA70631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice