Healthcare Provider Details

I. General information

NPI: 1467122218
Provider Name (Legal Business Name): SCHAEFER DENTAL GROUP-EAST LANSING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WATERTOWER PL STE 100
EAST LANSING MI
48823-8049
US

IV. Provider business mailing address

1500 WATERTOWER PL STE 100
EAST LANSING MI
48823-8049
US

V. Phone/Fax

Practice location:
  • Phone: 517-351-8442
  • Fax:
Mailing address:
  • Phone: 517-351-8442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BETH ANN WORKMAN
Title or Position: REGIONAL MANAGER
Credential:
Phone: 517-321-1848