Provider Demographics
NPI:1497778534
Name:SCHAFER, TIMOTHY E (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:E
Last Name:SCHAFER
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 1:1527 N POST RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4213
Mailing Address - Country:US
Mailing Address - Phone:317-895-6713
Mailing Address - Fax:317-895-6260
Practice Address - Street 1:1527 N POST RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4213
Practice Address - Country:US
Practice Address - Phone:317-895-6713
Practice Address - Fax:317-895-6260
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009493A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist