Provider Demographics
NPI:1124100987
Name:SNITZER, JEFFREY MARK (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MARK
Last Name:SNITZER
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 1:3000 W ESPLANADE AVE N
Mailing Address - Street 2:STE 200
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1877
Mailing Address - Country:US
Mailing Address - Phone:504-833-3200
Mailing Address - Fax:504-833-0813
Practice Address - Street 1:3000 W ESPLANADE AVE N
Practice Address - Street 2:STE 200
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1877
Practice Address - Country:US
Practice Address - Phone:504-833-3200
Practice Address - Fax:504-833-0813
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47601223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics