Provider Demographics
NPI:1235451956
Name:SCHAEPLER, CHARLES MARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MARK
Last Name:SCHAEPLER
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 1:315 WEST 11TH STREET
Mailing Address - Street 2:REGENCY SQUARE
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-7331
Mailing Address - Country:US
Mailing Address - Phone:308-234-9339
Mailing Address - Fax:308-234-1682
Practice Address - Street 1:315 WEST 11TH STREET
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-7331
Practice Address - Country:US
Practice Address - Phone:308-234-9339
Practice Address - Fax:308-234-1682
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5144122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE820540086-00Medicaid