Healthcare Provider Details

I. General information

NPI: 1083780464
Provider Name (Legal Business Name): SCHAEFER AND SCHAEFER FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4911 W ST JOSEPH HWY
LANSING MI
48917
US

IV. Provider business mailing address

4911 W ST JOSEPH HWY
LANSING MI
48917
US

V. Phone/Fax

Practice location:
  • Phone: 517-321-1848
  • Fax: 517-321-7757
Mailing address:
  • Phone: 517-321-1848
  • Fax: 517-321-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: BRIAN PATRICK SCHAEFER
Title or Position: CHIEF FINANCIAL OFFICER
Credential: DDS
Phone: 517-321-1848