MEDICARE: DR. ROBERT KENNETH SCHAFFER JR. D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7544	NC

General Provider Information

NPI Number	:	1558335505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT KENNETH SCHAFFER JR. D.D.S.

Provider Business Mailing Address
First Line	:	7643 MARKET ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-9458
Country	:	US
Telephone Number	:	910-686-9802
Fax Number	:

Provider Business Practice Location Address
First Line	:	7643 MARKET ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-9458
Country	:	US
Telephone Number	:	910-686-9802
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	09/29/2008

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