Provider Demographics
NPI:1093472136
Name:SCHAEFER DENTAL GROUP-NORTHVILLE PLLC
Entity Type:Organization
Organization Name:SCHAEFER DENTAL GROUP-NORTHVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-321-1848
Mailing Address - Street 1:42927 W. SEVEN MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167
Mailing Address - Country:US
Mailing Address - Phone:248-348-7997
Mailing Address - Fax:
Practice Address - Street 1:42927 W. SEVEN MILE ROAD
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167
Practice Address - Country:US
Practice Address - Phone:248-348-7997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHAEFER AND SCHAEFER FAMILY DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty