Provider Demographics
NPI:1558492975
Name:SCHAFFER & FIORENTINO DDS PC
Entity Type:Organization
Organization Name:SCHAFFER & FIORENTINO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:FIORENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:315-463-5627
Mailing Address - Street 1:6431 KIRKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9679
Mailing Address - Country:US
Mailing Address - Phone:315-463-5627
Mailing Address - Fax:315-437-8342
Practice Address - Street 1:6431 KIRKVILLE RD
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9679
Practice Address - Country:US
Practice Address - Phone:315-463-5627
Practice Address - Fax:315-437-8342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty