MEDICARE: DR. NATHAN W SCHAFFNER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6499	CO

General Provider Information

NPI Number	:	1730171935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN W SCHAFFNER DDS

Provider Business Mailing Address
First Line	:	1337 RIVERSIDE AVE STE 1
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-4373
Country	:	US
Telephone Number	:	970-893-4998
Fax Number	:	970-893-2903

Provider Business Practice Location Address
First Line	:	1337 RIVERSIDE AVE STE 1
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-4373
Country	:	US
Telephone Number	:	970-893-4998
Fax Number	:	970-893-2903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	02/06/2017

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