Provider Demographics
NPI:1235272212
Name:SCHAEFFER, DENNIS MEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MEL
Last Name:SCHAEFFER
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:P.O. BOX 187
Mailing Address - Street 2:261 NORTH MAIN STREET
Mailing Address - City:DOUSMAN
Mailing Address - State:WI
Mailing Address - Zip Code:53118
Mailing Address - Country:US
Mailing Address - Phone:262-965-3662
Mailing Address - Fax:262-965-3627
Practice Address - Street 1:261 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:DOUSMAN
Practice Address - State:WI
Practice Address - Zip Code:53118
Practice Address - Country:US
Practice Address - Phone:262-965-3662
Practice Address - Fax:262-965-3627
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5001622 WI.1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice