Healthcare Provider Details

I. General information

NPI: 1831291442
Provider Name (Legal Business Name): FRANK E SCHAFFER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: FRANK E SCHAFFER DDS

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 CUNNINGHAM AVE
JOPLIN MO
64804-1542
US

IV. Provider business mailing address

2602 CUNNINGHAM AVE
JOPLIN MO
64804-1542
US

V. Phone/Fax

Practice location:
  • Phone: 417-623-2000
  • Fax: 417-623-7948
Mailing address:
  • Phone: 417-623-2000
  • Fax: 417-623-7948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number11810
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5170
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: