Provider Demographics
NPI:1366895047
Name:SNIDER, SHAWN (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:SNIDER
Suffix:
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 1:10201 N OAK TRFY STE 300
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-4203
Mailing Address - Country:US
Mailing Address - Phone:816-429-6604
Mailing Address - Fax:816-429-6593
Practice Address - Street 1:10201 N OAK TRFY STE 300
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-4203
Practice Address - Country:US
Practice Address - Phone:816-429-6604
Practice Address - Fax:816-429-6593
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016019192122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist