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General NPI Number Information
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NPI Number | 1669582607
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Entity Type | Organization
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Legal Business Name | SCHAEFER AND SCHAEFER DMD PSC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7807 SHELBYVILLE RD STE 203
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City | LOUISVILLE
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State | KY
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Zip | 40222
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Country | US
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Telephone | 502-423-9555
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Fax | 502-423-7701
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Provider Business Mailing Address
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Address Line | 7807 SHELBYVILLE RD STE 203
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City | LOUISVILLE
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State | KY
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Zip | 40222
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Country | US
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Telephone | 502-423-9555
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Fax | 502-423-7701
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. DAVID A SCHAEFER
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Credential | DMD
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Telephone | 502-423-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6588
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3194
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License Number State | KY
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