Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 4760 | LA |
NPI | 1124100987 |
---|---|
Provider Name | Dr. Jeffrey Mark Snitzer |
First Address | Metairie, LA 70002-1877 |
Second Address | Metairie, LA 70002-1877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2007 |