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General NPI Number Information
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NPI Number | 1972002954
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Entity Type | Organization
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Legal Business Name | J SCHAEFER DDS INC
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 355 SANTA FE DRIVE SUITE 100
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City | ENCINITAS
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State | CA
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Zip | 92024
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Country | US
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Telephone | 760-390-6000
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Fax | 760-990-2252
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Provider Business Mailing Address
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Address Line | 355 SANTA FE DRIVE SUITE 100
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City | ENCINITAS
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State | CA
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Zip | 92024
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Country | US
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Telephone | 760-390-6000
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Fax | 760-990-2252
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFERY SCOTT SCHAEFER
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Credential | DDS, MSD
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Telephone | 760-613-2049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 62593
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License Number State | CA
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