Provider Demographics
NPI:1477567493
Name:SCHAEFER, ROBERT F JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:SCHAEFER
Suffix:JR
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 1:110 W UTICA ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-3047
Mailing Address - Country:US
Mailing Address - Phone:315-343-5430
Mailing Address - Fax:315-342-9974
Practice Address - Street 1:110 W UTICA ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-3047
Practice Address - Country:US
Practice Address - Phone:315-343-5430
Practice Address - Fax:315-342-9974
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3794811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice