Provider Demographics
NPI:1427351576
Name:SNYDER, LAURA A (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:SNYDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:GRABOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:4830 JUAN TABO BLVD NE STE K
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2682
Mailing Address - Country:US
Mailing Address - Phone:505-293-7611
Mailing Address - Fax:
Practice Address - Street 1:4830 JUAN TABO BLVD NE STE K
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2682
Practice Address - Country:US
Practice Address - Phone:505-293-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD22008122300000X
ORD9850122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500655535Medicaid