Provider Demographics
NPI:1952529851
Name:SNEAD, RAMON MACK JR (DDS)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:MACK
Last Name:SNEAD
Suffix:JR
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 1:508 W NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76106-9157
Mailing Address - Country:US
Mailing Address - Phone:817-625-0341
Mailing Address - Fax:817-625-1211
Practice Address - Street 1:508 W NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76106-9157
Practice Address - Country:US
Practice Address - Phone:817-625-0341
Practice Address - Fax:817-625-1211
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist