Provider Demographics
NPI:1346326733
Name:CHARLES M SCHAEPLER DDS PC
Entity Type:Organization
Organization Name:CHARLES M SCHAEPLER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHAEPLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:308-234-9339
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:ARAPAHOE
Mailing Address - State:NE
Mailing Address - Zip Code:68922-0510
Mailing Address - Country:US
Mailing Address - Phone:308-962-7811
Mailing Address - Fax:308-962-7811
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5144122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE505681651OtherBLUE CROSS BLUE SHIELD
NE505681651OtherBLUE CROSS BLUE SHIELD
NE=========01Medicaid