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1496 Southgate Ave Yellow Springs OH 45387-1244 | |
| (937) 767-8000 | |
| (937) 767-2542 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1496 Southgate Ave, Yellow Springs, Ohio |
| Authorized Official Name and Position | Nancy Fae Snyder (DENTIST) |
| Authorized Official Contact | 4198909978 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5641 W State Route 12 Findlay OH 45840-9394 Ph: (419) 890-9978 | 1496 Southgate Ave Yellow Springs OH 45387-1244 Ph: (937) 767-8000 |
| NPI Number | 1982996252 |
|---|---|
| Provider Enumeration Date | 05/05/2011 |
| Last Update Date | 05/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982996252 | NPI | - | NPPES |
| 2766190 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30022548 (Ohio) | Primary |