Provider Demographics
NPI:1306385034
Name:ROBERT K. SCHAFFER DDS INC
Entity Type:Organization
Organization Name:ROBERT K. SCHAFFER DDS INC
Other - Org Name:SCHAFFER DENTAL EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-481-1148
Mailing Address - Street 1:12750 CARMEL COUNTRY RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2159
Mailing Address - Country:US
Mailing Address - Phone:858-481-1148
Mailing Address - Fax:
Practice Address - Street 1:12750 CARMEL COUNTRY RD
Practice Address - Street 2:205
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2159
Practice Address - Country:US
Practice Address - Phone:858-481-1148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61261122300000X
CA38151122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty