Provider Demographics
NPI:1043211899
Name:SCHAFER, DUANE ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:ROBERT
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8887
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75404-8887
Mailing Address - Country:US
Mailing Address - Phone:254-212-1253
Mailing Address - Fax:866-399-2814
Practice Address - Street 1:520 N 12TH ST RM 315
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5064
Practice Address - Country:US
Practice Address - Phone:804-828-5687
Practice Address - Fax:804-828-6234
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000101581223P0106X
PADSO23468L1223P0106X
VA0414123141223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology