Provider Demographics
NPI:1427167311
Name:SNELL, CHRISTOPHER ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANDREW
Last Name:SNELL
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:PO BOX 5248
Mailing Address - Street 2:
Mailing Address - City:LAKE WYLIE
Mailing Address - State:SC
Mailing Address - Zip Code:29710-5003
Mailing Address - Country:US
Mailing Address - Phone:803-831-8856
Mailing Address - Fax:803-831-8966
Practice Address - Street 1:1100 VILLAGE HARBOR DR
Practice Address - Street 2:
Practice Address - City:LAKE WYLIE
Practice Address - State:SC
Practice Address - Zip Code:29710-9091
Practice Address - Country:US
Practice Address - Phone:803-831-8856
Practice Address - Fax:803-831-8966
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4365122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist